Section 11-45-159 - Specific requirements for the use of sources for brachytherapy(a) A licensee shall use radioactive sources in accordance with the manufacturer's radiation safety and handling instructions.(b) Safety instruction. (1) The licensee shall provide oral and written radiation safety instruction to all personnel caring for a patient receiving implant therapy. Refresher training shall be provided at intervals not to exceed one year.(2) To satisfy paragraph (1), the instruction shall describe: (A) Size and appearance of the brachytherapy sources;(B) Safe handling and shielding instructions in case of a dislodged source;(C) Procedures for patient control;(D) Procedures for visitor control;(E) Procedures for notification of the radiation safety officer or authorized user if the patient expires or has a medical emergency; and(F) Training for workers.(3) A licensee shall maintain a record of individuals receiving instruction required by paragraph (1), a description of the instruction, the date of instruction, and the name of the individual who gave the instruction.(c) Safety precautions. (1) For each patient receiving implant therapy a licensee shall: (A) Not place the patient in the same room with a patient who is not receiving radiation therapy unless the licensee can demonstrate compliance with the radiation dose limits for individual members of the public as specified in subchapter 4 at a distance of one meter from the implant;(B) Post the patient's door with a "Caution: Radioactive Materials" sign and note on the door or the patient's chart where and how long visitors may stay in the patient's room;(C) Authorize visits by individuals under eighteen years of age only on a case-by-case basis with the approval of the authorized user after consultation with the radiation safety officer;(D) Promptly after implanting the sources, survey the dose rates in contiguous restricted and unrestricted areas with a radiation measurement survey instrument to demonstrate compliance with subchapter 4 and retain a record of each survey that includes the time and date of the survey, a sketch of the area or list of points surveyed, the measured dose rate at several points expressed in millirems (microsieverts) per hour, the instrument used to make the survey, and the initials of the individual who made the survey; and(E) Provide the patient with radiation safety guidance that shall help keep the radiation dose to household members and the public as low as reasonably achievable before releasing the patient if the patient was administered a permanent implant.(2) A licensee shall notify the radiation safety officer or authorized user immediately if the patient expires or has a medical emergency.(d) Brachytherapy sources inventory. (1) Each time brachytherapy sources are returned to an area of storage from an area of use, the licensee shall immediately count or otherwise verify the number returned to ensure that all sources taken from the storage area have been returned.(2) A licensee shall make a record of brachytherapy source utilization which includes: (A) The names of the individuals permitted to handle the sources;(B) The number and activity of sources removed from storage, the room number of use and patient's name, the time and date they were removed from storage, the number and activity of sources in storage after the removal, and the initials of the individual who removed the sources from storage; and(C) The number and activity of sources returned to storage, the room number of use and patient's name, the time and date they were returned to storage, the number and activity of sources in storage after the return, and the initials of the individual who returned the sources to storage.(3) Immediately after implanting sources in a patient and immediately after removal of sources from a patient, the licensee shall make a radiation survey of the patient and the area of use to confirm that no sources have been misplaced. The licensee shall make a record of each survey.(4) A licensee shall maintain records required in paragraphs (2) and (3).(e) Release of patients treated with temporary implants. (1) Immediately after removing the last temporary implant source from a patient, the licensee shall perform a radiation survey of the patient with a radiation detection survey instrument to confirm that all sources have been removed. The licensee shall not release from confinement for medical care a patient treated by temporary implant until all sources have been removed.(2) A licensee shall maintain a record of patient surveys which demonstrate compliance with paragraph (1). Each record shall include the date of the survey, the name of the patient, the dose rate from the patient expressed in millirems (microsieverts) per hour and mervey.(f) A licensee authorized to use radiasured within one meter from the patient, and the initials of the individual who made the suoactive material for implant therapy shall possess a portable radiation detection survey instrument capable of detecting dose rates over a range 0.1 millirem (one microsievert) per hour to fifty millirems (five hundred microsieverts) per hour, and a portable radiation measurement survey instrument capable of measuring dose rates over the range one millirem (ten microsieverts) per hour to one thousand millirems (ten millisieverts) per hour. The instruments shall be operable and calibrated in accordance with section 11-45-141.[Eff 11/12/99] (Auth: HRS §§ 321-10, 321-11, 321-71) (Imp: HRS §§ 321-1, 321-11(21), 321-71)