General Directions for using
Aquaplast RT^® Bolus
 

Step 1

Place the supplied nylon mesh in the bottom of a shallow water bath, and then a large, unfolded paper towel on top of the mesh in the bath, pre-heated to approximately 165 degrees Fahrenheit.

Step 2

Place desired size of Aquaplast RT Bolus into the hot water and allow it to turn clear, with no whiteness/opacity to the material.  Once clear, remove the bolus by the ends of the mesh and allow the excess water to pour off the bolus into the pan.  Next, lay the bolus on a flat surface to check the temperature (you have a few minutes working time, so take your time). Check temperature by placing the inside of your wrist on the material, just as you would check baby formula on your wrist. Allow it to cool if necessary…you have lots of time.

Step 3

Moisten the area of the patient skin surface for application during simulation by wetting the target area with hand lotion, a water atomizer, or wipe on mineral oil with a paper towel.  Softened Aquaplast RT Bolus can be sticky, like a band aid to dry skin; pre-moistening the skin makes it easy to apply and remove. This step is only necessary during simulation.

Step 4

Once you have determine that the material is at a comfortable temperature, lift the Aquaplast RT Bolus on the mesh and paper towel and turn it over upside down on the area to be bolused (this is not necessary for small pieces). Peel off the layer of nylon mesh and then the paper towel (this technique prevents stretching of the material).

Step 5

Once the Aquaplast RT Bolus is applied to the target area, be careful not to stretch it, and mold the material using only light pressure to match the contours of the patient anatomy and hold.

Step 6

If you like, while the Aquaplast RT Bolus is opaque, outline the edges of the disease on the bolus with a Sharpie pen (dot technique is easiest), as well as mark it for S – superior, I – Inferior, L – Left, R – Right, patient name and distance.

Step 7

To speed up the cooling process, you may use a cold water soaked and wrung out cotton towel (for large bolus pieces), and a small cotton washcloth (for small bolus pieces), and lay it on top of the bolus. Turn the towel over every 20 seconds or so, until the bolus is completely white (you may need to re-soak and wring out the towel in the cold water if the towel has become warm). Using the wet towel technique will cause 4.8mm bolus to harden in approximately three to five minutes.  Once the bolus has hardened, it should be quenched in cold water to completely set.

Step 8

Check the underside of the Aquaplast RT Bolus to make sure you cooled it down sufficiently. The bolus should be cool to the touch.  Removing it while it is still warm will cause it to warp, and will thus cause it to not fit correctly during treatment.  If the Aquaplast RT Bolus does not fit properly during treatment due to swelling or decrease in target volume, simply re-soften it in the water bath, repeating the above steps. It can only be re-softened for use on the same patient, as it is classified for single patient use only by the FDA.

If you have any questions, please feel free to contact WFR/Aquaplast Corporation at 800-526-5247 or 201-694-8141.