Miriam Lane, Matthew Farrell, John Hegde
Quality improvement in radiation oncology has historically focused on technical precision, yet the management of acute medical emergencies during the radiation course remains under-addressed. The radiotherapy environment is defined by patient isolation and immobilization paired with high-density shielding and remote monitoring, creating a unique barrier to rapid intervention. This review analyzes critical scenarios including cardiac arrest, pediatric anesthesia complications, cardiac device malfunctions, and acute neurological events, along with other acute medical scenarios. By synthesizing current guidelines and modern data, we propose institutional frameworks to ensure clinical resilience and foster a culture of safety for this vulnerable patient population.