Short commentary

The Importance of the Y-90 Radiation Safety Time Out

David McKee RSC, Silas Williams, Kenneth Fearn, Adam Alli, Brandon Custer, Zachary Collins*

Department of Radiology, The University of Kansas Hospital, Kansas City, USA

*Corresponding Authour: Zachary Collins, Department of Radiology, The University of Kansas Hospital, Kansas City, U.S.A, E-mail:

Citation: Williams S, Fearn K, Alli A, Custer B, Collins Z (2018) The Importance of the Y-90 Radiation Safety Time Out. J Interv Radiol Nucl Med 2018: 51-52

Received Date: 29 September 2018; Accepted Date: 02 October 2018; Published Date: 12 October 2018

In today’s large medical centers, the increased output of interventional procedures has brought the awareness issue of safety to the forefront of all who work in and around the interventional radiology departments.  Interventional radiologists at our hospital have the highest occupational radiation exposure of all medical professionals, and their procedures represent the largest contribution of ionizing radiation exposure to patients.

Given these occurrences, the Radiation Safety Departments strive to create policies and training to establish a culture of substantially reducing radiation dose to both patients and staff. One such policy is the Y-90 radiation safety time-out sheet used to confirm and correct any mistakes before the radioembolization begins. The time-out sheet consists of several steps before the start of the procedure:

  • Patient, procedure, and site verification: This is done by verbal verification, with the written directive created by the Authorized User to ensure the correct patient and treatment site for every given procedure.
  • Dose verification: Verify that the prescribed dose for the patient is correct along with the pre-treatment guidelines.  The Authorized User has the option to change the treatment dosing if needed.
  • Procedural checklist verification: Verify that the type of procedure has the correct check list and the properly trained staff are ready to begin the procedure.
  • Radiation safety equipment verification: Ensure that all staff are wearing the appropriate safety equipment for the procedure; radiation dosimeter, ring for hand and finger exposure and leaded glasses with eye dosimeter for eye protection. Radiation monitoring badges must be worn at all times by the involved personnel in or around the procedure rooms. At no time should a staff member be allowed into a procedure room without the correct attire which includes a leaded skirt, a leaded vest, a thyroid collar protection, and shoe covers. Infraction of this rule may result in the loss of that person's privilege to work with radioactive material and/or ionizing radiation.

This intraprocedural radiation safety timeout is the last line of defines before implementation. It has already caught mistakes in action.  In a recent example, a verbal review of the patients demographics was found to be inconsistent with the expectation of the patients body habitus.  Review of the Sir Spheres microspheres activity calculator indicated that the patient was 110 kg. Meanwhile, the patient was visibly of quite low body weight and the dose was found to be calculated in kilograms rather than pounds. This would have led to an overdose of Y-90 to the patient. The dose was adjusted accordingly and the proper dose was administered. Additionally, laterality corrections and split dose administrations have been caught in a similar fashion.

Implementation of the radiation safety timeout, especially in high volume radioembolization centers, could significantly reduce procedure errors that could lead to higher radiation exposure to Radiation Safety personnel, staff and most importantly to our patients. It also provides documented information that ensures patients are receiving the best care.


  1. Chida K, Kaga Y, Haga Y, Kataoka N, Kumasaka E, et al. (2013) Occupational dose in interventional radiology procedures. AJR Am J Roentgenol 200: 138-141.
  2. Mahesh M (2001) Fluoroscopy: patient radiation exposure issues. Radiographics 21: 1033-1045.