Outline For A License

Use this outline to write up your license. To make it easier on you I suggest that you write a license for a cardiology clinic. Please follow the outline and the attached document.
  1. Purpose
    1. What is the reason for you’re your application – Cardiology/General/PET?
    2. What type of procedures are you planning on doing?  Patients/animals/research
    3. Type of license
  2. Location
    1. Where is the site located/address/room - you will need to draw a map to determine surveys and wipes (see below)
    2. Institution – Hospital – clinic – research facility
  3. Individuals Responsible - Authorizing personnel
    1. Who is managing the department? Identify Chief Technologist
    2. RSO
    3. Doctor – Board certified in what area? 35.???
    4. Who is going to be responsible for your radiation safety?
    5. What type of technologist(s) is/are going to be working for you?
  4. Facilities and Equipment
    1. Identify the room(s)
      1. Hot lab
      2. Imaging
      3. Waste disposal
    2. What is going to be shield
    3. Identify the equipment
      1. Equipment calibration - dose calibrator, well counter. uptake probe, and gamma camera
      2. Type of QC you will be doing on your equipment (as noted above)
      3. How often
    4. Leak test - How often, who will do it and on what?
  5. Personnel Monitor Program
    1. Who is going to be monitored?
    2. Who will be responsible for monitoring the radiation dosimetry reports?
    3. Radiation Safety Program
      1. Identify your radiation safety program
      2. Discuss basic radiation safety practices
      3. Relate to ALARA and state the use of the ALARA program
  6. Define “Rules for Safe Use of Radiopharmaceuticals”
  7. Identify radiation spill procedures
    1. Minor
    2. Major
  8. Discuss the process for ordering and receiving of radioactive packages
    1. How does this work with unit'
    2. Identify the ordering process
    3. What are the steps you follow when you receive a radioactive package
    4. What type of information do you use record for using unit dose
  9. Inventory of Sources
    1. How often should this be done
    2. At what level of activity
  10. Ambient Dose Rate Surveys (and wipe testing)
    1. Discuss the process for area surveys
    2. Note trigger levels
    3. If contamination is found, what do you do
    4. What do you record
      1. What are the maximum acceptable levels in dpm and mr/hr (restricted and unrestricted)
      2. What action would you take if its positive
      3. What is the role of the RSO
  11. Disposal By Decay-In-Storage (DIS)
    1. Unit doses are returned to the central pharmacy
    2. Other activity
      1. How is it disposed (sharps)
      2. Identify process on how it is put and storage and then released through normal trash
    3. What do you do with long-lived radio-isotopes
  12. Discuss the loss or theft of sealed and unsealed sources
  13. Discuss the security of licensed by-product material

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