When performed by an appropriately trained ABRET-credentialed technologist, an Ictal SPECT injection can be successfully completed. In their position statement, the ASET Board of Trustees recommends yearly radiation safety training along with documented ictal seizure onset recognition, and a valid R. EEG T. credential. The success of the ictal SPECT injection is directly related to injection time from seizure onset. When a trained technologist is in the same room with the patient and has view of the live EEG, the injection can be given very close to the ictal onset. The technologist familiarizes themselves with the patient's seizure type(s) and discusses with the epileptologist when and what to inject for. The technologist works with the patient during the week performing electrode application and maintenance and activation procedures, establishing trust and good rapport with the patient. In our practice, the patient's nurse verifies the function of the patient's IV access. The isotope is then connected via splitter tubing and clamped off with a clip. The technologist wears appropriate PPE and sits at the bedside with view of the EEG monitor near the patient. When it is time for the injection the IV tubing is crimped, the isotope clip is removed and pushed, then followed by saline flush. The patient event alarm is also triggered bringing in additional nursing help but the isotope injection by the technologist most always occurs before the nurse arrives. Radiation safety protocols are then carried out and the patient will go to CT for the study.
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