Lesson 1Injection technique to minimize extravasation: vein selection, tourniquet use, aspiration check, flushing, and securing injection siteThis section covers intravenous injection techniques that minimize extravasation, including vein selection, tourniquet use, aspiration, flushing, and site stabilization, and explains recognition, documentation, and management of infiltration events.
Patient assessment and vein selection criteriaTourniquet placement and vein visualizationAspiration check and slow, steady injectionSaline flush technique and line patency checksSecuring the injection site and patient positioningRecognizing and documenting infiltrationsLesson 2Contamination control and surveys: wipe tests, use of survey meters, frequency, acceptable limits, and action levelsThis section addresses contamination control in nuclear medicine, including routine surveys, wipe tests, acceptable limits, and response actions, with emphasis on documentation, decontamination methods, and prevention strategies.
Types of contamination and common sourcesUse and limitations of survey metersPerforming and interpreting wipe testsSurvey frequency and regulatory expectationsAction levels, decontamination, and re-surveyRecordkeeping and trend analysis for hotspotsLesson 3Dose calculations using time, activity, and patient weight: weight-based adjustments, decay correction, and pediatric/obese considerationsThis section reviews dose calculation methods using time, activity, and patient weight, including weight-based dosing, decay correction, and adjustments for pediatric and obese patients while respecting protocol and regulatory limits.
Basic activity, time, and decay relationshipsUsing decay factors and half-life tablesWeight-based adult dosing calculationsPediatric 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, administration routes, and typical adult activity ranges, emphasizing correct selection, labeling, 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 rangeIntravenous administration steps and checksContraindications 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 dose calibrator operation, including background checks, constancy testing, geometry effects, isotope setting, and time-of-measurement corrections, with emphasis on quality control records and troubleshooting.
Daily background and constancy proceduresQuarterly accuracy and linearity testing basicsGeometry dependence and volume considerationsSelecting correct isotope and calibration factorTime-of-measurement and decay correctionsQC documentation, 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 syringe technique, residual activity measurement, tare methods, and accurate documentation in the patient record.
Pre-injection activity measurement in calibratorSyringe positioning and reproducible geometryMeasuring residual activity after injectionTare method for syringe and shield correctionsCalculating net administered activityRecording activity, time, and technologist IDLesson 7Post-injection precautions for patients: restroom use, hydration, discharge instructions, and breastfeeding guidanceThis section explains essential post-injection instructions, including restroom use, hydration, contact restrictions, and breastfeeding guidance, to reduce radiation exposure to family, public, and staff while preserving image quality.
Immediate restroom use and bladder emptyingHydration strategies to enhance tracer clearanceLimiting close contact with infants and pregnant womenWritten discharge instructions and key counseling pointsBreastfeeding interruption and milk storage guidanceWhen 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 vial management, syringe preparation, shielding, labeling, and regulatory requirements to minimize exposure and prevent loss or misadministration.
Receiving, unpacking, and inspecting shipmentsVial handling, venting, and aseptic techniqueNeedle and syringe selection and secure assemblyUse of lead pigs, syringe shields, and dose traysLabeling, transport containers, and DOT categoriesSpill prevention 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 technologist workflow, room layout, and patient scheduling, highlighting practical strategies to reduce occupational dose and monitor compliance with regulatory limits.
Time minimization during high-exposure tasksMaximizing distance using layout and toolsOptimizing shielding for staff and public areasRoom design, hot lab zoning, and traffic flowUse of dosimeters and review of exposure reportsPregnant worker considerations and declarations
