Technologists Tips:
Proper Injection Techniques

By Rebecca Sajdak, BA, CNMT, RT(N)

When administering any radioisotope, regardless of the route of administration, the technologist must do the following:

Do’s

1. Confirm Patient’s identity by two methods: A) Name-have patient clearly state full name and spelling. B) Birth date verbally stated by the patient. Inpatients, use identification bracelet and chart to identify correct patient and test

2. Confirm pregnancy status on females under the age of 55.

3. Confirm correct study, correct isotope & correct amount of isotope

4. Explain procedure to patient and answer questions prior to injection

5. Always use aseptic technique to draw dose and ensure fresh needle is in place for injecting into patient.

6. Place the extremity in a dependent position (lower than the patient’s heart because gravity slows venous return and distends the veins).

7. If injecting into an existing line, aseptically swab the port and then flush With normal saline to ensure patency

8. When preparing isotope to inject, ensure that the preparation is in accordance with the package insert instructions

9. When performing a tagged red blood cell study, ensure the blood is placed in a heparinized vacutainer and inverted several times to insure homogeneity. Use largest gauge needle possible to re-inject the tagged RBC’s

10. Record the dosage, time, route of injection, and any additional relevant information (i.e., chance of infiltrate, etc.) & signature. Infiltration of PET doses of F-18 FDG will invalidate SUV data for that patient.

Don’ts

1. Do not recap needle. If completely necessary to recap, use the one hand method or needle cap holder

2. Never push air out of syringe once dose is drawn.

3. Do not inject without correct syringe shield for isotope

4. Don’t assume anything. Only inject with syringe that is labeled with name, study, isotope, date & time

5. When patient has had mastectomy, never inject in arm coinciding with surgically removed breast; never inject in arm with fistula present

6. Never inject stannous pyrophosphate (Cold PYP) through any plastic tubing or existing port (i.e., butterfly, IV line, fistula, PIC line, heparin lock etc.) Do not inject pertechnetate in same site as PYP

7. Once a dose has been drawn, never return to a container. This practice avoids product contamination as well as misadministrations.

8. Do not draw back blood into syringes containing Tc99m MAA. This can cause clotting of the dose and an altered biodistribution resulting in difficulty interpreting the scan. If dose is contaminated with blood, discard the dose and draw a fresh one.

9. Do not dispose of any radioactive waste (i.e., bandage, gauze) in regular trash

10. A needle is designed for single use, good for one venipuncture only, whether it’s the vial or a patient

RULE OF THUMB: When in doubt, Throw it out!!!

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