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Whats New in the
Patient Safety World
October 2024
MRI Special Patient
Considerations
A recent article in the journal European Radiology (Santini 2024) highlighted some special considerations in vulnerable patients undergoing MRI scanning. Examples include comatose patients, unconscious patients, anesthetized patients, febrile patients, pregnant patients, infants, patients with large body habitus, claustrophobic patients, and autistic patients.
A photo of second degree burns to the insides of an obese patients thighs is shown. The authors note that in obese patients or those with large body habitus, skin-to-skin or skin-to-bore contact may be problematic. Use of appropriate padding to avoid such contact is required. There is also a higher probability of experiencing peripheral nerve stimulation since a larger body diameter brings the skin of the patient also closer to the bore surface, where absolute values of gradient fields are higher. Also, an implanted device such as a pacemaker might find itself in an area of higher spatial gradient with respect to the same device implanted in a person with a smaller habitus.
In the anesthetized patient, impaired thermoregulation and consequent hypothermia are concerns, so monitoring the patients temperature is important. Of course, you must also be sure the anesthesia equipment is MRI safe.
Likewise, in infants, impaired thermoregulation puts them at risk for both hypothermia and hyperthermia. Proper fitting of ear protection is necessary.
Even the febrile patient can be considered to be vulnerable. Scanning, even in normal mode, can cause a temperature rise of up to 0.5 °C, which can be relevant in febrile patients. Allowing heat dissipation and using low-SAR (specific absorption rate) sequences are important measures to avoid hyperthermia.
Overall, this is a good article that raises issues we often dont think about and good suggestions for addressing those issues in all the categories mentioned above.
Some of our prior columns on patient safety issues related to MRI:
·
February 19, 2008 MRI Safety
· March 17, 2009 More on MRI Safety
·
October 2008 Preventing Infection in MRI
· March 2009 Risk of Burns during MRI Scans from Transdermal Drug Patches
·
January
25, 2011 Procedural
Sedation in Children
· February 1, 2011 MRI Safety Audit
· October 25, 2011 Renewed Focus on MRI Safety
· August 2012 Newest MRI Hazard: Ingested Magnets
·
October
22, 2013 How
Safe Is Your Radiology Suite?
·
October
21, 2014 The
Fire Department and Your Hospital
·
August
25, 2015 Checklist
for Intrahospital Transport
·
August
2016 Guideline Update for
Pediatric Sedation
· October 2016 MRI Safety: Theres an App for That!
·
January
17, 2017 Pediatric MRI Safety
·
August
8, 2017 Sedation for Pediatric MRI
Rising
·
March
2018 MRI Death a Reminder of
Dangers
·
March
2018 Cardiac Devices Safe During
MRI But Spinners!?
·
November
2018 OMG! Not My iPhone!
·
April 2,
2019 Unexpected Events During MRI
·
September
2019 New MRI Hazard: Magnetic
Eyelashes
·
October
15, 2019 Lots More on MRI Safety
·
November
5, 2019 A Near-Fatal MRI Incident
·
November
2019 ECRI Institutes Top 10
Health Technology Hazards for 2020
·
January
7, 2020 Even More Concerns About MRI
Safety
·
March
2020 Airway Emergencies in the
MRI Suite
·
October
2020 New Warnings on Implants and
MRI
·
January
2021 New MRI Risk: Face Masks
·
June 1,
2021 Stronger Magnets, More MRI
Safety Concerns
·
November
2021 Yet Another Risk During MRI
·
January
2022 MRI Safety Issues
·
July 26,
2022 More Risks in the Radiology
Suite
· October 24, 2012 Serious MRI Accident at Unregulated MRI Center
· November 21, 2023 Another Terrifying MRI Accident
· January 2024 Guns and MRI Dont Mix
· February 20, 2024 What is a Safety Case?
· June 11, 2024 Nursing in the MRI Suite
· August 13, 2024 Preventing Thermal Injury During MRI
References:
Santini, F., Pansini, M., Deligianni, X. et al. ESR Essentials: advanced MR safety in vulnerable patientspractice recommendations by the European Society for Magnetic Resonance in Medicine and Biology. Eur Radiol 2024; Published September 6, 2024
https://link.springer.com/article/10.1007/s00330-024-11055-1
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