MRI Safety Awareness The purpose of this healthstream presentation is to educate the hospital staff that do not routinely come into the MRI environment. It is meant to be a basic educational piece to increase the awarness of the safety hazards that surround the MRI suite.

Objectives Identify hazards surrounding the MRI environment. Discuss safety precautions to protect patients, family members and staff against possible dangers and injury within the MRI suite. Discuss the importance of accurately completing the mandatory MRI pre-screening form.

MRI Hazards The MRI contains a very powerful magnet. This magnet is always on! -even when the machine isn’t scanning, including all night, every weekend , and even holidays. This magnet is so strong it will pull heavy items( such as oxygen cylinders, chairs, beds, and stretchers) into the scanner. The magnetic field cannot be seen, smelled or heard, but it is always present. The magnet attracts all ferro(iron)-magnetic objects, including: Implants in patients or staff Objects in pockets Tools and equipment These objects are attracted by the magnet. Such objects can become powerful projectiles and can cause serious injury or even death. There have been documented cases where patients have been killed in the MRI suite. The MRI magnet is always on. We never turn it off. Anything that is ferrous, will be attracted to the magnet and should never be taken into the MRI room. There have been people killed by not following these guidelines.

Examples of Dangerous Ferro-magnetic Materials Staff chair was sucked into the magnet when brought into zone 4 Patient Related Oxygen Cylinders Wheelchairs Stretchers/beds IV poles & drug pumps Some patient implants Staff Related Firefighting equipment Cleaning equipment Floor Buffers Buckets, etc Hand tools Keys and watches Guns & metal handcuffs Credit cards will be demagnetized. This slide shows what can happen when ferrous items are taken into the MRI room. This event took place her at CHKD. I can’t say enough or stress the importance of not taking items that are ferrous into the mri room.

Special MRI Equipment Tools and patient-care equipment that are specially designed for use in the MRI suite are made without ferrous material and they are clearly labeled. If there is no label assume that the item is not safe to enter the MRI suite. Again, if in doubt, leave it out. As stated before, non ferrous items are ok to enter the MRI room. This is one of our MRI safe medication infusion pumps. IT is specially designed to operate safely in the mRI environmenat and is not attracted to the magnet.

What Equipment is MRI Safe? Equipment that is not “ferro-magnetic” can be brought into the MRI suite Special non-ferrous material must be used for items such as screw drivers, fire extinguishers cleaning tools and IV poles. MRI safe tools are clearly labeled If in doubt, leave it out and always check with the MRI staff Items that are safe to enter the MRI room are clearly marked. We have the manufactures label, also we have add an additional label for our staff to recognize. If you are not sure about the item’s safety, do not take it into the MRI room.

MRI Safety Signs Warning signs at the entrance of the MRI suite, alert you that you are entering an area with special hazards. Always follow all instructions and be aware of your surroundings. The magnet is a powerful and dangerous piece of medical equipment and should be treated accordingly. Another measure that we have in place, is signage. There are signs indicating that you are entering the mri environment.

MRI Zone Categories The MRI suite is divided into 4 safety zones. ZONE 1: This region includes all areas that are freely accessible to the general public. It is typically outside of the MR environment itself and is the area through which patients and all hospital personnel access the MR suite. This zone is not marked or labeled. ZONE 2: This area is between the accessible zone 1 and the strictly controlled zones 3 and 4. Patients and other personnel are able to move throughout this area. However they must be mindful of where zone 3 begins. This area is marked with a safety sign. Our MRI waiting room is considered ZONE 2.

MRI Zone Categories ZONE 3: This area is the region that non MR safe equipment can result in serious injury or death if accidentally moved closer or into zone 4. Hospital personnel are not to move freely through this zone. They must be accompanied by level 2 staff. MR safe practice guidelines must be adhered to for the safety of the patients and other non-MR staff. ZONE 4 : This zone is the MR suite itself. Nobody that has not been screened will enter this zone under any circumstances. If the screening process has taken place, you may enter the suite but you MUST be accompanied by level 2 MR staff. Other than the waiting room, our entire MRI suite is considered ZONE 3. The magnet room is ZONE 4.

Safety Measures Most MRI related incidents have been due to deficiencies in screening methods and or lack of properly controlling access to the MRI environment, especially with regard to preventing personal items and other potentially harmful objects into the magnet room.

MRI Safety Measures The following are measures to protect against possible dangers within the MRI suite: Staff pre-entry screening Staff awareness MRI safety signs Knowledge of hazards of magnetic field Use of special non-magnetic equipment Follow and respect instructions from MRI staff If in doubt about any object, leave it out Always see MRI staff before entering the suite We have several measures in place to help protect patients, visitors, and employees from the dangers of the magnet. We screen all individuals that are to enter the room. We have signs clearly posted to warn of the dangers of the magnet, our staff is very knowledgable and will educate anyone that is to enter the room. We have purchase MRI safe equipment to be use in the MRI room. Also, anyone wishing to enter the mri room must contact the MRI level 2 employee first.

What you need to do before entering the MRI suite Always consult with the MRI staff before entering the MRI suite. Never go into the room unattended. There are some things that you need to do and know to ensure your safety when working around the Magnet. Never go into the Mri room unattended. A level 2 employee should be with you at all times

Knowledge and understanding of what the hospital MRI safety policy stipulates is a must. Knowledge is always the best policy. Familuaize yourself with the MRI safety policy if you know that you will be expected to enter the MRI environment.

Pre Entry Screening The MRI staff will give you a MRI screening form that you must fill out prior to entering the MRI suite. The need for accuracy is vital. There may be articles inside of your body that will disqualify you from entering the MRI suite. Some examples: slivers of metal from an injury, pacemakers, implants from prior surgery, etc. **All items must be removed from your pockets prior to entry. Pagers, wallets, keys, scissors, etc. The first measure that I mentioned previously was the screening form. It is imperative that this form is fully and accurataly completed.

Completely and accurately fill out the MRI pre screening form If you are planning on going into the MRI room, you must fill out a screening form prior to entering.

When viewing the order set for MRI, the safety questions should be completed.

It’s Not Just the Patient The MR system is surrounded by a very strong magnetic field which may be hazardous to individuals entering the MR environment. Hazards include metallic, electronic, magnetic or mechanical implants, devices or objects. All individuals are required to fill out the pre-screening form prior to entering the MR environment or room.

The magnet makes an extremely loud noise while obtaining images The magnet makes an extremely loud noise while obtaining images. Therefore, if you will be staying in the room during scanning you must wear ear protection. The patient and any other person that is going to be in the MRI room, is encouraged to use ear protection. The fast changing of the electrical gradients create noise while in operation. Some of the sequences, if exposed to for long periods can create Hearing loss.

All of your pockets must be emptied to ensure that nothing that is ferrous enters the MRI environment. All jewelry must be removed. Again, if you are entering the MRI room, everything in your pockets must be removed as well as all of your jewelry.

Even in an emergency situation, never rush into the MRI suite If there is a code, you should not dash into the room. The technologist is able to bring the patient out of the room. If that isn’t and option you should quickly remove your belongings then enter the room under the supervison of the MRI staff. We aren’t trying to be difficult, we just want to make sure that there isn’t anything on you or in you that could cause bodily harm to you or others.

Emergency Procedures All safety procedures must be followed, even in an emergency situation. An MRI shut down is a lengthy and costly process called a quench. It takes more than just a flick of a switch to shut down the MRI magnet. Dangerous gases are expelled during a quench and all personnel must be moved out of the MRI Suite for their safety. Always report any problems immediately to the MRI staff Once again, if in doubt if something is MRI safe, leave it out and always ask the MRI staff. In the rare case of an equipment emergency where bodily harm may take place, an MRI shut down is possible. This is called a quench, Helium which helps keep the magnet cool and magnetized, is released. There is ventilation for the helium to exit into the atmosphere, however, there is always the danger of it being released into the room. All personelle must be removed for their safety.