Emergency Situations

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Can we please get your advice on this one question?

Emergency situations are one of the worst situations in the field of radiotherapy. Emergency are the one it leads to potential damage to personnel involved during that time. The emergency situations would be different for different type of machine. It will be classified on the basis of machines using in the field radiotherapy.

Till now three classifications of emergency situations are found.

1. Emergency situation in Teletherapy (Telecobalt machines)

2. Emergency situation in Teletherapy (Linear Accelerators)

3. Emergency situation in Brachytherapy (LDR&HDR)

Emergency situations in teletherapy (Telecobalt Machine):

In External beam radiotherapy (EBRT) two types of machines are used to treat the patients. One is Radioisotope based machine and other is Linear Accelerators.
Radioisotope based machine used in radiotherapy is telecobalt machines. In that different emergency situations are there.

1. The major emergency situation could be happen in the telecobalt machines is source stuck in between the off and on position.

2. Another emergency situation in the telecobalt machines are source gets fell down during the changing of the new source from the source drawer.
Emergency situation in Teletherapy (Linear Accelerators)

In EBRT, Linear Accelerators based radiotherapy centers also having the emergency situations. The emergency situations are,

1. In linear accelerators, miscalculation of monitor unit by the chambers is one of the most considerable emergency situations.

2. Any change in the treatment planning system should be informed to the medical physicist. Because unaware of the change in TPS leads to a miscalculation in treatment time. Example: Panama incident is one of the best example for this type errors lead a emergency situation.

3. Malfunction of the machine by allowing the 15 MV instead 10MV. To avoid these emergency situations preventive maintenance of the machine should be done periodically.

Emergency situations in Brachytherapy (LDR&HDR):

1. One of the emergency situations in brachytherapy are source gets stuck inside the catheter or inside the stainless needle in the implants

2. Other emergency situations are source gets stuck in between the catheter and machine.

3. In LDR, sometimes while removing the source needles radiation therapist fails to remove all the needles properly. Sometimes may break during the insertion or removing time. It could leads to emergency situations.
In All these situations should be handled by certified Radiological Safety Officer (RSO) and Engineer to resolve the problem under the guidance of regulatory body. Others are not allowed; strictly publics are not allowed to enter the area. If, the RSO found any emergency situation immediately cordon off the area is the first line action after that, should inform to the concern regulatory body and to the employer of the institution is important.

Questions:

1. Who is the authorized to handle the emergency situation?

a) Radiation Therapist

b) Medical Physicist

c) Certified Radiological Safety Officer and Engineer of the particular machine

d) Radiation Oncologist

Answer -- c) Certified Radiological Safety Officer and Engineer of the particular machine

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