IES2025 Case Reports E-Posters (18 abstracts)
Case series: the multidisciplinary approach to facilitating radioactive iodine therapy in those with complex care needs
Rachel Byrne , Laura Sinclair , Una O’Connor , Hannah Reilly , Aoife Gaffney , Colin Walsh , Mandy Lewis , Christina Domsa , Geraldine O’Reilly & Marie-Louise Healy
St James Hospital, Dublin, Ireland
Introduction: Radioactive iodine (RAI) therapy with 131I is a key pillar in the management of thyroid malignancy and thyrotoxicosis. Specialised isolation rooms are used for radioiodine ablation, while thyrotoxicosis is usually an outpatient treatment. Patients undergoing RAI therapy are typically self-caring making adherence to radioprotective measures straightforward. Occasionally patients with complex biological, psychological and social circumstances are referred requiring careful consideration.
Methods: A retrospective observational study detailing the extensive work of our multidisciplinary team to ensure equal access to this important therapy, despite individual care needs. We describe the distinct clinical and radiation protection considerations for three unique cases.
Results: Three patients with a learning disability and resultant inability to perform independent self-care. These cases include uncontrolled grave’s disease and papillary thyroid cancer across both outpatient and inpatient settings respectively. Our cases highlight solutions for challenges including dysphagia, behavioural difficulties, contamination whilst handling bodily excreta and waste management. In addition, the challenge of patient wellbeing in an unfamiliar/isolated environment, acceptable risks to comforter/carer and an approach to those with no obvious choice for comforter/carer are also addressed. Finally, managing staff anxiety when navigating unfamiliar risks also poses significant challenges.
Conclusions: Complex cases require a tailored therapy approach. This minimises occupational exposures and ensures compliance with regulations without compromising overall care. Clear communication with the MDT, the patient and their carers to develop a customised plan is imperative. A significant effort and often bespoke approach are critical to ensure equal and safe access for all.
Volume 115
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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