10.3 Brachytherapy Inpatient Precautions

Patients receiving temporary brachytherapy implants and patients administered permanent brachytherapy implants that do not meet the patient release criteria (i.e., the maximum dose to any individual from exposure to the released individual is likely to exceed 500 mrem) require the following isolation precautions while they remain in the hospital.  Patients administered permanent implants that meet release criteria, but require hospitalization for other medical reasons, are normally isolated while hospitalized in order to control radiation exposure.  Bodily fluids and excreta from brachytherapy patients do not represent a radioactive contamination or exposure hazard. 

  • Unless otherwise noted, hospitalized patients containing brachytherapy implants require a private hospital room with a private bath.
  • Cesium-137 and Iridium-192 implant patients are normally required to be admitted to a lead-lined room on 3 JPP.
  • I-125 eye plaque and prostate patients (when applicable) are housed in a private room on 3 RCP.
  • The door of a radioactive materials therapy patient’s room is required to be posted with a “Caution – Radioactive Materials/Radiation Area” warning sign.
  • Complete Part A of EHS’s “Radiation Protection Guidelines for Patients Treated with Radioactive Materials” form and attach it to the patient’s chart.
  • Contact EHS to arrange for patient monitoring immediately following the brachytherapy administration.  An EHS representative will perform the required patient dose rate measurements and complete Part B of the “Radiation Protection Guidelines for Patients Treated with Radioactive Materials” form and attach it to the patient’s chart.  The completed form provides patient specific information regarding radiation exposure levels, recommended attendant and visitor stay times, and other patient care guidance.  This information is also posted on the door to the patient’s room.
  • Pregnant visitors or staff and individuals under the age of 18 are normally not permitted in a radioactive material therapy patient’s room. 
  • Patients treated with therapeutic quantities of radioactive materials are normally confined to their rooms except as necessary for medical or nursing procedures.  Brachytherapy patients should remain in bed unless otherwise medically ordered.
  • If a temporary implant source or applicator becomes dislodged, contact the attending or on-call Radiation Oncologist at once.
  • Permanent implants used for treating prostate cancer can be passed in the patient’s urine.  It is therefore important to strain the urine for a prostate cancer patient.  
  • Never handle a brachytherapy source directly.  If a dislodged source or applicator is discovered on or near the patient, use long forceps or other remote handling tools to move it to an unoccupied area of the room.  Notify EHS immediately.
  • Temporary brachytherapy implants must be removed from the patient at the prescribed time.  Contact the attending or on-call Radiation Oncologist immediately if the sources are not removed as scheduled.
  • All brachytherapy patient linens, surgical dressings, and trash should be saved in the patient’s room until surveyed for radioactive material and released by EHS or Radiation Oncology. 
  • Patients receiving temporary brachytherapy implants can be released only after the attending Radiation Oncologist has removed all sealed radioactive sources from the patient and performed a radiation survey of the patient’s body.
  • Following brachytherapy patient release, the room and its contents cannot be released until Radiation Oncology or EHS completes a radiation survey.