Implementation of a two-prong fail-safe alert for detecting radioactive iodine therapy patients returning to the hospital

1166 Background: We describe cases at 2 different institutions where patients were treated with I-131 NaI and returned to the Emergency Department (ED) several days afterwards for medical care; in both cases the significance of prior radioactive iodine (RAI) treatment was not appreciated from the patient history or the medical chart. Discussion: Staff in the ED may not appreciate the implications of RAI therapy and the need for subsequent safety precautions. Instructions to the patient may not be conveyed to the caregivers for a variety of reasons, including incapacity. In the current health-care environment, patients may also appear at a facility other than where they received RAI and there may not be a history of treatment available in the patient9s chart. Intervention: We discuss several possible interventions which can be performed to minimize this scenario, highlighting a two-pronged solution which has been implemented across a regional hospital network, comprised of both physical (wrist-band) and electronic (chart alert) components. Experience and issues related to implementation of these measures will be described including communication with stakeholders, protection of patient privacy, and the need to minimize radiation exposure and contamination to individuals.