Flash FAX : 2008-05-19 - MRI SAFETY CONCERNS

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Flash FAX

      MRI SAFETY CONCERNS:  Recently we had the chance to review some safety
      issues relating to the use of MRI in pediatric patients.  Further, the
      JCAHO released a sentinel event update on MRI safety in February 2008.  In
      light of the current interest and the potential risk involved, I asked
      Elizabeth Ey, MD, to provide an update for the professional staff as well
      as others who refer to our medical imaging division.  Her thoughtful
      review of the problem is presented for your information.
      Recently, the JCAHO published a sentinel event alert regarding safety
      concerns in MRI.  The alert reported numerous serious injuries and even
      several deaths, which have occurred in the MRI environment.  The medical
      imaging department at Dayton Children's has had in effect for several
      years an MR Safe Practice Policy, which follows the guidelines established
      by the American College of Radiology.  Strict adherence to the policy
      prevents these MR related injuries from occurring.  It is important to
      review the safety concerns for referring physicians and health care
      The majority of the reported injuries and deaths are related to the
      magnetic force exerted on ferromagnet objects (missile effect), magnetic
      effect on metal implants and foreign bodies (heating and burns) and
      magnetic effect on electrical or mechanical implants (electric or
      mechanical malfunction of implants).  It is critical to remember that the
      magnetic field is very strong and is always on, even at night when the MRI
      is not being used.  The MR scan room is always carefully attended or
      locked.  Only people who have been screened for safety concerns are
      allowed in the scan room and only under the approval of the MR
      technologist in attendance.
      The missile effect refers to a metal object being propelled through the
      air by magnetic force and smashing into the magnet and anything in its
      path.  Oxygen cylinders, IV pumps and wheel chairs are examples of
      ferromagnetic objects, which have caused significant injury and death to
      patients and staff in the MRI environment.  Any object not certified to be
      MR safe is strictly prohibited in the MR scan room.  Heating and serious
      skin burns can occur from the magnetic effect on wires, cables and tattoos
      on the skin.  Remember the physics of inducing an electrical current
      through a wire loop using a magnet?  Electronic equipment such as
      pacemakers, implanted infusion pumps and defibrillators will malfunction
      in the MR environment.  Some valves for CSF shunts are programmed using a
      small magnet.  These will need to be reset after the MR exam in order to
      resume correct function.
      The MR technologist is responsible for screening anyone wishing to enter
      the MR scan room and the high magnet field environment.  The questionnaire
      is lengthy but vitally important to prevent injuries and ensure safety. 
      If there is any doubt about the safety of an implant or device in the MR
      environment, the study will be postponed until it is determined safe to
      proceed or an alternate imaging study will be performed.  For further
      information please refer to the MR Safe Practice Policy or contact
      Elizabeth H. Ey, MD, in the medical imaging department at 937-641-3204.


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