Lesson 1Injection technique to minimise extravasation: vein selection, tourniquet use, aspiration check, flushing, and securing injection siteThis section covers intravenous injection techniques that minimise extravasation, including vein selection, tourniquet use, aspiration, flushing, and site stabilisation, and explains recognition, documentation, and management of infiltration events.
Patient assessment and criteria for vein selectionPlacement of tourniquet and visualisation of veinAspiration check and slow, steady injectionTechnique for saline flush and checks for line patencySecuring the injection site and patient positioningRecognising and documenting infiltrationsLesson 2Contamination control and surveys: wipe tests, use of survey meters, frequency, acceptable limits, and action levelsThis section addresses control of contamination in nuclear medicine, including routine surveys, wipe tests, acceptable limits, and response actions, with emphasis on documentation, methods of decontamination, and strategies for prevention.
Types of contamination and common sourcesUse and limitations of survey metersPerforming and interpreting wipe testsFrequency of surveys and regulatory expectationsAction levels, decontamination, and re-surveyRecordkeeping and analysis of trends for hotspotsLesson 3Dose calculations using time, activity, and patient weight: weight-based adjustments, decay correction, and paediatric/obese considerationsThis section reviews methods for dose calculation using time, activity, and patient weight, including dosing based on weight, correction for decay, and adjustments for paediatric and obese patients while respecting protocol and regulatory limits.
Basic relationships of activity, time, and decayUsing decay factors and half-life tablesCalculations for weight-based adult dosingPaediatric dosing and minimum activity limitsAdjustments for obese or very small adultsChecking calculations against protocol rangesLesson 4Common radiopharmaceuticals and administration routes: Tc-99m sestamibi/tetrofosmin for myocardial perfusion (IV), Tc-99m MDP for bone scan (IV); typical adult activity rangesThis section reviews commonly used technetium-99m radiopharmaceuticals, their indications, routes of administration, and typical adult activity ranges, emphasising correct selection, labelling, and documentation for myocardial and skeletal imaging.
Tc-99m sestamibi: indications and adult dose rangeTc-99m tetrofosmin: indications and adult dose rangeTc-99m MDP: indications and adult dose rangeSteps and checks for intravenous administrationContraindications and common adverse reactionsDocumentation of product, lot, and administered doseLesson 5Dose calibrator operation: daily background check, constancy test, geometry considerations, setting correct isotope and time-of-measurement correctionsThis section details routine operation of dose calibrator, including background checks, testing for constancy, effects of geometry, setting of isotope, and corrections for time-of-measurement, with emphasis on records for quality control and troubleshooting.
Daily procedures for background and constancyBasics of quarterly accuracy and linearity testingDependence on geometry and volume considerationsSelecting correct isotope and calibration factorCorrections for time-of-measurement and decayDocumentation of QC, trends, and troubleshootingLesson 6Activity verification steps: measuring drawn and administered activity, syringe technique, tare weight method, and documentationThis section explains how to verify activity before and after administration using a dose calibrator, including technique for syringe, measurement of residual activity, tare methods, and accurate documentation in the patient record.
Measurement of pre-injection activity in calibratorPositioning of syringe and reproducible geometryMeasuring residual activity after injectionTare method for corrections of syringe and shieldCalculating net administered activityRecording activity, time, and technologist IDLesson 7Post-injection precautions for patients: restroom use, hydration, discharge instructions, and breastfeeding guidanceThis section explains essential instructions after injection, including use of restroom, hydration, restrictions on contact, and guidance on breastfeeding, to reduce radiation exposure to family, public, and staff while preserving image quality.
Immediate use of restroom and emptying of bladderStrategies for hydration to enhance tracer clearanceLimiting close contact with infants and pregnant womenWritten discharge instructions and key counselling pointsInterruption of breastfeeding and guidance on milk storageWhen to escalate concerns to the nuclear medicine physicianLesson 8Safe handling and transport of radiopharmaceuticals: vial handling, needle/syringe best practices, use of lead shielding and dose traysThis section details safe handling, packaging, and transport of radiopharmaceuticals, focusing on management of vials, preparation of syringes, shielding, labelling, and regulatory requirements to minimise exposure and prevent loss or misadministration.
Receiving, unpacking, and inspecting shipmentsHandling of vials, venting, and aseptic techniqueSelection and secure assembly of needle and syringeUse of lead pigs, syringe shields, and dose traysLabelling, transport containers, and DOT categoriesPrevention of spills during preparation and transportLesson 9Radiation protection principles (ALARA): time, distance, shielding applied to technologist workflow and room layoutThis section applies ALARA principles of time, distance, and shielding to workflow of technologist, layout of room, and scheduling of patients, highlighting practical strategies to reduce occupational dose and monitor compliance with regulatory limits.
Minimisation of time during high-exposure tasksMaximising distance using layout and toolsOptimising shielding for staff and public areasDesign of room, zoning of hot lab, and traffic flowUse of dosimeters and review of exposure reportsConsiderations and declarations for pregnant workers
