Nuclear Cardiology: Nuclear Cardiology:

270 Nuclear Cardiology, The BasicsEXAMPLESThe following are illustrative examples of written policies from ourlaboratory (see also the ICANL website www.icanl.org)Example 1. Dose Calibration and Administration• Every radioactive kit prepared must have a Dose Log Sheet.• The log sheet must contain the radiopharmaceutical, date, total activity in kit in mCi, total volume used in kit, concentration (activity inmCi/volume in mL), and time the kit was prepared.• Every patient dose must be logged on the Dose Log Sheet with patientname, procedure (Stress or Rest), and time.• To calculate the concentration at the time of injection:Take the original concentration and multiply by the decay factor(Tc-99m decay chart hanging on bulletin board).• To calculate how much isotope to draw up:Dose desired (mCi) / new concentration (mCi/mL) = volume todraw up (mL).• Assay the dose in the dose calibrator.• Adjust the dose as necessary to get the desired dose.• Label the dose with the patient name, activity, time, and isotope.• Record actual dose drawn up on Dose Log Sheet.• Important: A patient can only be injected with ± 10% of the desireddose. If the dose is adjusted for the patients weight, note on the logsheet and refer to the Tc-99m Adjusted Dose Chart.• Pediatric patients (< 18 yr old) must have their dose adjusted for theirweight using the following formula:[weight (lb) / 150 (lb)] × adult doseexample: child of 50 lb, usual adult dose = 25 mCithus, (50 lb /150 lb) × 25 mCi = 8.33 mCi to be given to this childNote: nonstandard dosing should be given only after consultationwith the nuclear cardiologist.• All doses should be carried in a lead carrying case or lead pig. Alldoses should be in a lead syringe shield during injection.• All injections are done through a three-way tubing for rest and exercise tests, or a Y-connector for adenosine and dobutamine tests.• The port should be swabbed with an alcohol pad prior to injection.• Rest and exercise injections should be flushed with 10 cc of normalsaline.