Spill of F-18 FDG in the Hot Lab

Priority order (people → containment → contamination control → recovery):

1. Stop and secure: announce the spill, stop work, and have everyone leave the immediate spill area without spreading contamination. Do not let anyone walk through it.
2. Decontaminate the person first: the technologist's hand/forearm - remove contaminated gloves and lab coat carefully (inside-out), wash skin with lukewarm water and mild soap, and survey (get a meter from the PET suite or use a backup). Repeat washing until survey shows acceptable levels; do not abrade skin.
3. Contain the spill: if safe, cover the liquid with absorbent pads/paper towels from the edges inward to prevent spreading; mark the area and restrict access. Do not use the floor drain or sink - F-18 must not be flushed; it would contaminate the drainage system.
4. Control access: post signs, keep the hot lab closed, and divert the 08:00 patient (notify the scheduler/physician).
5. Notify the RSO and document time, activity, location, and personnel involved.

Key point: Person decontamination and preventing spread come before cleaning the floor, and the drain/sink are off-limits.

Decontamination:

• Don double gloves, shoe covers, and a gown; work from the outside of the spill inward.
• Use absorbent pads to blot (don't wipe/spread), then clean with detergent and water in small sections, changing pads/gloves frequently and placing all waste in a radioactive waste bag.
• Do not use the drain or sink. Collect all liquid and cleaning materials as radioactive waste.
• F-18 has a short half-life (110 min), so contamination decays quickly, but you still decontaminate and verify rather than wait.

Verification without the primary meter:

• Retrieve the survey meter from the PET suite as soon as possible, or use a backup/calibrated meter. You cannot declare the area clean without a survey.
• Survey with the probe at a fixed distance (e.g., 1 cm) over a grid of the area; compare to background and to the department's contamination action level (e.g., a defined multiple of background or a fixed Bq/cm² criterion).
• Re-survey after each cleaning cycle until readings are at/below the action level; record results and the final clearance.

Do not release the room based on visual inspection or elapsed time alone.

Skin dose/contamination implications:

• F-18 emits positrons (511 keV annihilation photons); external dose from contamination is significant, and internalization (through broken skin, mouth, or inhalation) is the main concern.
• Skin contamination is assessed by survey and, if needed, skin dose estimation. The skin dose from a small contaminated area is generally managed by prompt decontamination; the priority is to prevent internal contamination and to confirm the skin is clean by survey.
• If contamination is not removable, or if internalization is suspected, escalate for bioassay/internal dose assessment and medical evaluation.

Follow-up and reporting:

• Document the incident: activity, location, personnel, decontamination steps, survey results, and any residual contamination.
• Notify the RSO and complete the required incident/occurrence report per the facility's regulatory obligations; some frameworks require reporting of spills above defined activity thresholds or any personnel contamination.
• Review the event (root cause: unshielded handling, no secondary containment, missing meter) and implement corrective actions - e.g., secondary containment trays, a dedicated hot-lab meter, and spill drills.