See forward the contingency: A pioneer BLS drill for patient taken radioactive iodine-131

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Authors (including presenting author) :
To CN, Lam PYW, Wong MC, Ngar YK, Tin WY, Liu TC, Mak KI, Fung LC
Affiliation :
Department of Clinical Oncology, Tuen Mun Hospital, New Territories West Cluster
Introduction :
Radioactive iodine (I-131) is an adjuvant treatment for thyroid cancer patients to improve disease free survival by destroying suspected but unproven residual disease, especially in those at increased risk of disease recurrence. Patient taken ablative dose radioactive I-131 will cause radiation hazard to healthcare workers and special arrangement had to be implemented. Patient will be arranged in a single room with lead shield and time exposure for nursing care will be kept as short as possible. However, clinical condition may change unexpectedly and Basic Life Support (BLS) maybe required. Additional guidelines have to be implemented in balancing the radiation hazard for health care worker and life-saving procedure. In order to be prepared for such contingency, a BLS drill for I-131 patient was conducted. This is the first BLS drill for radioactive I-131 patients in our oncology department.
Objectives :
1. Frontline staff will be able to be familiar in BLS for radioactive 1-131 patients 2. Act as a pioneer for BLS drill (for radioactive I-131 patients) which will be held regularly in the future.
Methodology :
2. Two core principles for BLS for radioactive I-131 patients: keep exposure time less than 15 minutes and need for rescuer rotation after every 15 minutes for each rescuer were identified by workforce group. Rescuers are also required to put on Direct-Read Personal Pocket dosimeter prior to enter single room for measuring the radiation received. 3.3. The core principles was emphasized and integrated into the BLS drill 4.A checklist for BLS for radioactive I-131 patients was created. 5 BLS drill for radioactive I-131 patient was conducted on December, 2017 6 Debriefing and drill report were conducted and completed and make available to all departmental staff.
Result & Outcome :
1. All participants were able to be familiar with the procedure in dealing with BLS for radioactive I-131 patients 2. All participants and stakeholders agreed that the BLS drill can act as a pioneer as it shaped the detail of the drill and also identified key core principal. This can facilitate the regular BLS for radioactive I-131 patients 3. All frontline nursing staff accredited the effectiveness and usefulness of the BLS checklist for radioactive I-131 patients.

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