Regulations permit the outpatient treatment or release from hospitalization of any individual who has been administered permanent brachytherapy implants containing radioactive material, if the total effective dose equivalent (TEDE) to any other person coming into contact with the released individual is not likely to exceed 500 mrem. In addition, the regulations also require that written instructions recommending actions to maintain doses to other individuals as low as reasonably achievable be provided if the total effective dose equivalent to any other person coming into contact with the released individual is likely to exceed 100 mrem.
If the dose to a breast-feeding child of a mother treated with radioactive materials could exceed 100 mrem (assuming there is no interruption of breast-feeding), the written instructions shall also include guidance on the interruption or discontinuation of breast-feeding, and information regarding the consequences of failure to follow the guidance.
The determination of the suitability for outpatient treatment and release of patients receiving medical administrations of radioactive material is the responsibility of the administering authorized user, requires that the patient can reasonably be expected to follow written instructions, and concurrence of EHS. Records of the basis for authorizing patient release shall be maintained for a minimum of 3 years. Records that dose reduction and/or breast-feeding discontinuation instructions were provided where applicable shall also be maintained. The responsibility for communicating the radiation safety dose reduction instructions to the patient rests with the authorized user physician who administered the radioactive material.