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IKN-RS-SOP-15: Death Body Containing Radioactive

DOCUMENT NO.   :  IKN-RS-SOP-15

INTRODUCTION

Radioactive materials used for medical treatment generally involve greater quantities of radioactivity (than is used for diagnostic purposes). It may be non-penetrating (so that little if any radiation emerges from the body of the patient who effectively acts as a shield) or it may also have a penetrating component (meaning that other people in the close vicinity of the patient will receive some exposure to radiation coming from the radioactive material within the patient). In the rare event that a patient dies within a medical facility after undergoing treatment with radioactive material, the RPO or delegated physicist should be consulted before any procedures, such as laying out or post-mortem are commenced and before the body is released for embalming, burial or cremation.

 

PURPOSE

To guide individuals and centers where nuclear medicine procedures are undertaken for handling deceased body containing radioactive material. It is recommended that good radiation protection practice should be implemented in the interest of reducing radiation exposure and risks to the workers and public.

 

RESPONSILIBILITY

  • Radiation Protection Officer (RPO)
  • Radiation Workers
  • Physicist
  • Nuclear Medicine Physician

 

FREQUENCY

Upon case.

 

EQUIPMENT

  • Survey Meter
  • Contamination Meter
  • Pocket Personal Dosimeter
  • Personal Protective Equipment (PPE)

 

PROCEDURE

Death of patient undergoing radioactive therapy

  1.  If the patient dies during the treatment, the Nuclear Medicine Specialist shall consult the Physicist on how to minimize exposure to the person handling the body. The movement of the body should be minimised, using strict procedures for prevention of contamination from body fluid, until the RPO arrived.
  2. Body fluid may be radioactive and catherisation of the cadaver should only be performed under the direct supervision of the RPO.
  3. Deceased body released for autopsy, embalming, cremation or burial above the limit as mentioned in Table 1 should have a label identifying the radionuclide and its activity at the time of release, together with a release statement signed by the RPO according to the IKN-RS-F-043 Patients Death During Radionuclide Treatment Released Form.
  4. Transportation of a deceased body containing radioactive shall follow the ALARA (As Low As Reasonably Achievable) concept.
  5. Other practical measures for dealing with deceased body shall include;
    1. Notify the relevant people who will be handling the deceased body.
    2. Staff involved in handling a deceased body should wear proper disposable gloves, gowns and pocket dosimeter.
    3. RPO or designated personel shall measure the radiation level from the deceased body and estimate the time of exposure allowed to the staff.
    4. Material or equipment that has come into direct contact with the dead body shall be checked for contamination at the end of the procedure.
    5. Prepare relevant documentations and notify the appropriate authority within 24 hours.
    6. All details regarding radiation exposure from the deceased body containing radioactive material and personnel involved shall be recorded.

 

Handling of radioactive bodies in the wards

  1.  The following procedures shall be followed;
    1. The Physicist shall advise and supervise on radiation safety issue to the relevant staff.
    2. In future procedure need to be done on the deceased body, the fact that it may still contain radioactive material should not be neglected. Proper handling should be carried out to minimise unnecessary radiation exposure to other staff.
    3. Staff should wear protective gown, gloves, and pocket dosimeter during handling the deceased body in order to avoid radionuclide contamination.
  2. The deceased body shall have a separate yellow wrist radiation-hazard band, in addition to regular identification wrist band starting that radioactive material is present in the deseased body.
  3. A minimum contact to the deceased body should be attempeted (e.g. replacement of false teeth) if necessary.
  4. All the details regarding radiation exposure from the deceased body and the personnel managing the body were recorded in IKN-RS-F-050 Radioactive Death Body Radiation Monitoring Record.

 

Transfer of deceased body containing radioactive material from the ward to the mortuary

  1.  The body should be removed from the ward as soon as possible after death.
  2. In the mortuary, the body should be kept at the section of the body storage refrigerator far from easy accessibility by other personnel. This is to minimise potential radiation exposure to staff who may be working in the mortuary.

 

Transfer of deceased body containing I-131 from the ward to the mortuary

  1.  Exposure of individuals to radiation emitted by therapeutic radioactive materials retained on a dead body can be reduced by adopting any or all of the following precautions;
    1. Remove the radioactive materials where possible.
    2. Plan ahead in order to reduce the time of exposure.
    3. Work at a respective distance from the dead body to reduce radiation exposure.
    4. Work with adequate shielding where possible.
  2. RPO or Physicist must be consulted on the radiation protection matter whenever an autopsy is performed or discharge of the body.  
     15 Table1

 

Precaution for autopsy

  1. Procedures for personal protection normally observed during an autopsy to provide adequate protection agains external radiation exposure or contaimination with radioactive material if the radioactivity level for the deceased body is less than the activities shown at Table 1 above.
  2. If a deceased body contains an activity in excess of the levels shown at Table 1 and the autopsy cannot be postponed for a suitable period for radioactive dacay, the pathologist should be informed of the radiation levels likely to be encountered and od the hazards involved. The methods employed and the precautions adopted should be chosen accordingly in consultation with the RPO or Physicist.
  3. If it is known that the radioactive material used for treatment will have been selectively absorbed in a particular organ. The organ should be excised and removed from the work area before the autopsy examination proceeds. It may later be disposed of with the body after consultation with the RPO.
  4. The fluids from the procedure shall be disposed via the sewerage system. The equipment should later be decontaminated by trorough rising in a detergent solution followed by washing in running water.

 

Procedure for transportation of the decease body to the burial

  1.  All deceased body released for burial and cremation contains an activity in excess of the levels shown at Table 1 should have a label attached, identifying the radionuclide and activity at the time of release, together with a release statement signed by RPO or Physicist.

REFERENCES

  1. Atomic Energy Licensing (Basic Safety Radiation Protection) Regulations 2010.
  2. Radiation Protection in Nuclear Medicine, Radiation Protection Series Publication No. 14.2, ARPANSA 2008.
  3. Applying Radiation Safety Standards In Nuclear Medicine, Safety Reports Series No. 40 IAEA 2005.
  4. Release of Patients After Radionuclide Therapy, Safety Reports Series No. 63, IAEA 2009.

 

DISCLAIMER

This Standard Operating Procedure (SOP) was developed based on compilation of best available information, knowledge, field experience, and general practices to provide guidance to IKN staff in performing the activities defined herein, in a consistent and standardised manner.
IKN does not guarantee nor accept any legal liability whatsoever arising from or connected to the accuracy, reliability, currency or completeness of any material contained herein.
IKN shall take no responsibility for and will not be held liable for this document being temporarily unavailable due to technical issues beyond our power and control.