MRI Safety 101: Educating patients and healthcare providers on screening forms and procedures

Episode: MRI Safety

- Introduction
- Incident with a patient who failed to inform medical staff about a bullet in their body
- Importance of informing healthcare providers about potential risks
- Screening forms for patients before MRI appointments
- Role of the ACR in setting safety standards for MRI procedures
- Importance of the ACR's MRI safety manual
- Heating risks when metal objects are present during a scan
- Advising patients to inform medical staff about non-natural metal objects
- Ensuring patient safety by knowing about all foreign objects
- Issues with oxygen tanks at the speaker's previous hospital
- Transition to MRI safe oxygen tanks throughout the hospital
- Oxygen setup in most hospitals and potential safety risks with wheelchair oxygen tanks
- Confusion around filling out forms and understanding CAT scans vs MRI scans
- Importance of safety measures for the well-being of both patients and MRI technologists
- Need for everyone to change before entering a medical facility
- Importance of following safety protocols and benefits for providers and patients
- Challenges with unconscious patients and completing screening forms
- Involving a family member or guardian for written consent or involving two witnesses for verbal consent
- The speaker's positive experience working in pediatrics and the hospital's well-organized MRI safety procedures
- Removal of pain and medication patches, tobacco patches, and glucose monitors before MRI
- Importance of asking patients about these items and educating them about necessary preparations
- Calling patients ahead of time or using an MRI safety officer to ask questions before their MRI appointment
- Importance of patient understanding and proper attire for an MRI session
- Incident with an object flying into the scanner during a medical procedure
- Importance of being careful and following safety protocols to prevent accidents
- Issues with MRI scanners, especially with detachable tables for patient transfer
- Need for stronger and more solidly built MRI safe stretchers for patient transfers
- Emphasis on respiratory care during the transferring process
- Conclusion and final thoughts

bullet, patient, inform, healthcare provider, potential risks, MRI scanning, screening form, appointment, ACR, American College of Radiology, accreditation company, safety standards, manual, metal objects, non-natural metal objects, foreign objects, patient safety, hospital, oxygen tanks, MRI safe oxygen tanks, confusion, filling out forms, CAT scans, MRI scans, safety measures, MRI technologists, own well-being, medical facility, safety risk, unsafe objects, safety protocols, unconscious patients, family member, guardian, information, consent, verbal consent, witnesses, pediatrics, children's hospital, MRI safety procedures, multiple facilities, pain patches, medication patches, tobacco patches, glucose monitors, necessary preparations, calling patients, MRI safety officer, set of questions, dressed for MRI session, medical procedure, n

Buzzsprout - Let's get your podcast launched!
Start for FREE

Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.

Transcript

0:40

hi, I'm your host Sharia. I am the host of a couple of Rad Tech's podcast, and this episode is going to be amazing MRI Safety 101: Educating patients and healthcare providers on screening forms and procedures as they all are, but we're gonna talk specifically about MRI safety. Many people wonder. Why do I have to put on a gown? What I wore cotton clothing. I wore exercise clothing. There's no zippers, there's no metal on. Why do I have to change or why do I have to fill out that screening form every time I get an MRI? Just had one. Nothing's changed. Why do I have to fill out another form? And many people don't understand the difference between a CAT scan and an MRI scan. They're like, well, the last time I got in here fully clothed, they just asked me to slide my pants down. I didn't have to change yet, or, Are you sure I should bring my purse in here? Because the last time they had me lock everything up. So I'm going to talk to you as a MRI technologist, as a radiologic technologist about the safety measures that we take not only for patients, but also for ourselves as M MRI technologists. Yes, we have to go through the same screening as patients. Yes, I bet many of you did not know that. And if anything changes with us, It could also alter how we perform our job or if we can perform our job at all. So first things first. MRIs are fascinating. They are amazing. They are a way to see very detailed imaging of the body, particularly when you know. That something's going on. Say you have a mass on your liver, uh, you have a mass anywhere in your body. There's not clear definition after you've had an ultrasound, after you've had a a mammogram, after you've had an x-ray, after you've had a CT scan, which is great for detail or a CAT scan and some people call it. Now the doctors want to really zero in and look deeper before they ever have to do surgery or any kind of, uh, procedure that is more invasive. M r i is the next best thing. It is the Cadillac of imaging. Yes. When you're trying to get more detail and definition of whatever the question is, when it comes to someone's problem or their issue with their health, you turn to mri. As radiologic technologists, we get specialized training to become MRI technologists, you have to go through, uh, several courses for number one safety. That is the first thing when I took my course I had to go through was number one, safety. Safety for myself and safety as I actually perform the MRI scan on patients. And the reason is because many people think projectile. Yes, metal objects can be. Become projectiles and they will go across the room and injure someone. And even yes, the unthinkable, yes. Beyond injuring. You know what I'm talking about? They could end someone's existence. So we have to be very, very careful and very, very safe. In my many years of doing M r I, fortunately I have not had personally any of those incidents happen to me, but I've come close. Things happen to you guys. I, I, I'll tell you, if you stay tuned, I'll give you two things that have happened to me personally and Whew. Scared the jibes outta me. Yes, it made me more focused on being safe when it comes to mri. Some people, and some patients may think I go overboard, but I let them know. 21 years of doing this, I have never injured or hurt anyone and never injured or hurt myself. So I plan to keep that record going, So most patients after that go, yeah, and I'm gonna help you keep it going because I don't wanna be your first person that that happens to. Right? So it is a team effort. One thing we also worry about is the magnetic field moving implantable devices around in your, in your body. That is another thing. Also, the third thing we worry about is making sure that the patient does not experience any burning. Yes, the metal in your body is. And your skin can become seriously burned and burns become infected, and we just don't wanna go down there that, that direction, that rabbit hole. So we avoid not only projectile of metallic objects, pH magnetic objects, we also avoid the shifting or moving of things that are implanted. We want them to stay exactly where they are, but the MRI machine does have the power to move things around. We don't want that. Also burning. You can burn from a mri. It heats things up. And if you've got metal that is not a safe type of metal, it will get hot. Whether it's in your body, on the outside of your body, it gets hot and that is not good. So we ask that Patients always let us know what's going on with them, what do they have in planet, and I'm gonna give you a few things that you may not think. Our implants, my thing to my patients, if, if you weren't born with it, let me know. if you weren't born with whatever is in your body, let me know. I don't judge, but I wanna make sure you're safe. I'm gonna give you a few of those things, examples of those things that you definitely, definitely wanna let us know before we do your scan, before we bring you into that room, before we lay you on that table. I've had patients forget to tell me they had a bullet in their body and yeah. There was a bullet and it was in a bad spot. We're in trouble here, but don't tell me once you get on the table and I'm getting ready to slide you into the scanner. That's not the time. The time is when we give you a screening form, so most patients will get a MRI screening form either prior to their appointment that they fill out and then fax back to your doctor's office, or you get the screening form when you come in and check in for your appointment. You fill it out before you come back, then what happens? We follow what we call the ACR R guidelines, and the ACR is an accreditation. Uh, it's an accreditation, uh, company that actually, uh, gives us standards that we want to operate in when it comes to MRI and other radiology things. But basically they have a manual MRI safety. We as technologists fill out a screening form that stays on record, so I've gotta fill'em out too. And we annually fill those out to make sure that nothing has changed. Because people, I've worked with people that have done MRI for a long time and they had to have a pacemaker. They weren't able to get past certain zones to be able to complete their job. So either they went back to another modality or they moved outta radiology altogether. Um, and the ones that did, they were pretty sick, so they did not return to work. They either retired or were disabled. So those are things that would stop you from being able to. Do your job, and it's important that your employer know that. So we actually fill out screening forms as technologists. Again, we do them annually, depending on your facility. They may do it every six months, but at least every 12 months, technologists have to do them. So we gotta do it. Everybody's gotta do it. And when a patient comes in, each time you come in, we need to have you look over that screening for'em again, make sure nothing has changed. You'd be surprised at things that change within a week. I had a patient once came for several scans. Everything was no, no, no, no, no, no, no. This one time the front desk person decided, Hey, they're regular here. They don't need to fill out the screening firm. I'm just gonna make a copy of the one. They had a few. Month. I think it was like a month or so ago. I'll just make a copy and just change the date on it. Patient didn't sign it, anything. I get it back. I see it's a copy and I'm like, mm. Did the patient look over this to make sure nothing has changed? Oh, she was just here. Yeah, but she still needs to look over it here. She still need needs to look over it to make sure nothing has changed. So I bring the patient back and I go over everything and she's like, oh yeah, I've got a pump. Implant it into me now. Doctor, just put it in. Exactly. So that is why we always make sure the patient fills out the actual form. So what if the patient is sedated or unable, mentally unable to do it? Well, they either have, um, someone, a family member or someone that speaks for them that we contact to make sure. So working in the, uh, trauma hospital, um, a hospital period, we get patients that come in. They're either un unresponsive and they need to have an M R I. We still have to do a screening for'em. We can't just say, oh, now there have been instances where the person is a Jane Doe, a John Doe. There's no record of anyone we can call. They've never been to our hospital before. I've had this happen before. What do we do? What happens? Do we just skip MRI safety? No, we don't. We actually take that person through a X-ray series pretty much they X-ray you from head to toe to make sure there's no metal in your body anywhere. So they'll either. Usually they don't send you in CAT scan. They'll do an x-ray. You literally x-ray the skull, chest, abdomen, pelvis, the, the major areas where if there was a bullet or was a a, a pacemaker or a defibrillator, we can see it. If there was an aneurysm clip, you know, we can see that on the x-ray. Metal in the eyes and his shavings of metal in the eyes. We can see all that. So you know, that is how we get around that. So, but I can't make that judgment as a technologist. The radiologist makes the final say. So he gets, or she gets that series of x-rays and then they do what's called a clearing or a clearance scan. They actually make a report. They actually read it and make a report, and it's in the patient's chart. They've had this. X-Ray series done for MRI clearance and a radiologist has given a report that they are all clear and safe to get an mri. Now, even in emergency situations, we do not because we will cause harm. We don't know what's inside of patients. And even if you're a regular patient, we just don't know. Things change. I'll tell you this instance. So one thing you ma, I promise you, I would tell you some things to maybe you didn't think about. Antimicrobial underwear. They are a thing you guys. They have certain in those antimicrobial, uh, underwear, underpants, uh, clothing, they have metal fragments in them, and that can burn you. That is why number one, we do not allow your facility should not allow you to get an MRI with any clothing on the policy across the board is for MRI safety, is that every. Patient that is going into the scanner needs to change. They have to change into a hospital approved gown. Now, caveat, I get patients from the floor that have certain gowns on, on the floor. We know where they are. The ones with the snaps, they gotta come out of those. Like I'm gonna tell you, I follow the rules because the rules are there to protect myself and the patient. I make sure the reason I take them off is twofold. Number one, the patient. You know, has usually like two gowns on. It's a bunch of snaps and it's gonna be in the way of the brain. And by the time you get somebody in there and there, you got tubes and everything, you might as well just take that gown off. Um, pop it, slide it out, slide it out from the other side. Throw one of your MRI safety. A gown is a gown. They can go back up to the floor with it. It, it's belong by the hospital So I, the one that they have with the snaps on and, and other thing is a lot of those gowns that come from the floor have EKG leads stuck all inside of the gowns, not on the patient, but inside of the gowns. Those are not MRI, safe EKG leads. They have to come off. So as I'm checking the patient who comes from the floor or from the er, I'm rolling them up. So as I roll'em up to check their back and make sure there are no e k G leads on them. I'm just pulling that gown off the, has those snaps. Do it all at once, and that way you don't run into the issue of now it's been sitting on this elderly patient's, very fragile skin, and it heats up and burns them. You don't know until they get back to the floor and now risk management is calling you and it's a issue. And now this patient. It's burned because you didn't check for EKG leads, you didn't check for, uh, the snaps on the gown. So to me it just, you know. Then pain patches, that's the other thing. Pain and medication patches, they gotta come off. Tobacco, um, patches where people, uh, are trying to quit smoking, those have to come off and there's this new thing where people have the glucose monitors on. There's a little needle inside. So you wanna make sure you ask those questions to patients and make sure patients are educated, informed. So one thing that I do is call my patients ahead of time, uh, or if you're in a bigger facility, They work together with your MRI safety officer and they have a set of questions they ask people before they come in for their mri. And those questions, you know, will, will kind of run through so that you as a patient know, number one, how to come dressed to your appointment. You wouldn't believe how many people make it harder, uh, for themselves for the MRI scan because they come full of jewelry. Bedazzled shirts and jeans, all of that stuff has to come off. All of that stuff has to come off girdles. I mean, just, I understand you probably got somewhere else to go after that, but if you do dress like, just know that you have to come outta all of that stuff. So we have to, we have to change you out of it, even if you come and exercise equipment, because. Many. Not many. I'll change my word. There are a number of athletic clothing lines that have metallic thread. Yes. And there are documented cases of patients wearing them into the scanner and coming out with burns. So they're fashionable, they're cute, they're easy to slip on and slip off, and you may think there's no danger. There is the danger, and that's where we as professionals come in and really, and educating our patients. I don't have much pushback from patients because I make sure I tell you this is what can happen. You have the option. Not to have the scan, uh, but it would just be in your best interest. I make everyone change, and this is the other reason, when you get patients, people are so frequent back to facilities and if they went to this facility and that facility said, no, you didn't have to change. Oh, just come in. Um, now they come to the next facility or the next tech that works at that facility and they're like, well, the last tech didn't make me change. They just told me I had, I was fine with this on and just checked my pockets and they wandered me down. But if anything was to happen, they, they got through that time. And patients sometimes are scanned with unsafe things in them. And I'll give you another example. A situation where say a patient has been scanned over and over with the bullet, a bullet in their body, and nothing's ever happened. Well, the one time you go to scan him and you happen to say, no, we're gonna get an x-ray series to see where this bullet is. The bullet is sitting next to the aorta and it entered through the buttocks. Yeah. How did that happen, And imagine if you did not employ MRI safety, you would've maybe Potentially. Potentially. Potentially. I mean, is that a word? Potentially, uh, caused harm to the patient, and it's so important to. Always, always, always screening for'em. Change patients, uh, and stick to the R safety protocols and it will save you in the long run and save the patient as well. Now we talked about if patients weren't conscious, they weren't able to do their screening form, um, you know, what do you do? Those are all ways to get around it. You definitely have a family member, a guardian, someone who can speak for them, get it in writing. If it's a verbal, say the patient, you have to call the family member. It's a verbal. You have two people, myself, another tech that will witness, we fill out the form what the person tells us, and we both sign date time. They put the person's name and their relationship. You wanna do all of those things. It's important when. You have patients that are unresponsive, unconscious, altered mental state, uh, just not able to fill their own forms out themselves to document properly. This is all part of MRI safety. Um, when you transfer patients, making sure, like even down to the sheets and pillows, you guys, I mean, like you may think I'm being petty, but Mr. Safety is really important. You. Inadvertently make, it's not the oxygen tank mistakes that most of us make. At least in my, my years, I've never had a problem with oxygen tanks. One hospital I worked at like, it was so complicated with oxygen tanks. I just didn't bring them in there at all. They did not come past that room because, I was used to working at a facility that had the orange tops on all of their MRI safety, safe oxygen tanks, and eventually that hospital invested in having all MRI safe oxygen tanks throughout the hospital. They slowly made that transition over, so you were always good It was always good, but most hospitals have oxygen in the wall. You never have to worry about an oxygen tank because it's flowing through the hospital and it's through the walls. You don't have to worry about it. That's excellent. But many hospitals don't have that, so you have to make sure that that oxygen tank isn't on the back of the wheelchair, which happens a lot of times. Even on mri. Safe wheelchairs, some facilities stopped allowing, uh, the. MRI safe wheelchairs to have the attachment where the oxygen tank set in. That way it cut down on the le on accidents happening where one, someone would leave an oxygen tank in the back of an MRI safety, uh, wheelchair. If it's not there to hook on or hang on, you know, it will, it shouldn't happen. But pillows and sheets are so important because number one, EKG leads get stuck to anything. They're on the sheets, they're on the pillows, pillow covers, anything that comes from the floor. I just. To leave on the bed when I transfer the patient over to the MRI table. I don't take anything over, honestly. I use my own blankets outta my department. I use my own sheets, my own gowns. I take everything off. It's just not coming in the room with me. I've had too many close calls and I've seen too many things happen to where it's like, oh my goodness. That could have been a big disaster. been a big, big disaster. Um, you have the MRI scanners now where you can detach the table and bring it out of the room, especially when I c u patients come down and you have to do a transfer over from their bed because they bring them down on a bed and you have to do a transfer over. You used to have to. Actually transfer them over onto an MRI safe stretcher, which is a little flimsy cuz it's almost like putting somebody on an aluminum foil. I'm sorry to say that, but I wish they were a little stronger. They're kinda rickety, um, because they're not that solid kinda build because they are MRI safe. So, you know, but, and. It's just you have to just, you know, it's a lot of transferring when you're doing all that cuz you just got respiratory there. The nurses, every, this person is critical. So when you got those MRI scanners that had a detachable table that was amazing. It was beautiful. Which made our jobs a lot easier. Uh, and I think it cut down personally on the accidents. That's just my opinion. You were moving from one main table to the proper table that was just, Just amazing. Now, when it comes to pediatric patients, uh, I worked in peds for several years. Loved it. Can I say that anymore? I loved it. If I went back to a hospital, I'm pretty sure I would go back to peds. I'm, I'm almost a hundred percent If I went back, if I had to go back full time to a hospital, I'm almost positive I would go back to pediatrics and I'll tell you why. Um, it's run like a well oiled machine when it comes to MRI safety. In my opinion, I've never worked in any other facility that is so like boom, boom, boom, boom, boom. And this was before MRI safety officers ever came, you know, up with a certification. I feel like the children's hospital that I worked at across the board, whether I was at the hospital, the outpatient centers, they have multiple facilities and they're just huge now. I feel like they were always ahead of the game. Because they dealt with pediatric patients. That's really important. But any patient, it's important to be that way. I didn't understand why the adult hospitals were not where they were. Uh, every life is important. Um, the best care for everybody is important to me. And being safe for all patients is important. No matter if it's pediatrics or adult. I mean, okay, that's just my opinion, but I'm gonna tell you, if I go back to the hospital, it'll probably be children's. Uh, definitely children's. Uh, kids are fun. It's always something fun going on at the children's hospital, but, When it comes to the safety, I only had one incident at a hospital where the doctor wear lab coat, but I'm gonna tell you, you gotta be buzzed into the MRI department. You're just not gonna walk in there. I mean, everything's locked down in these pediatric hospitals. The bathroom is probably even locked down but everything's locked down. You gotta be buzzed through to come through the MRI department. We have our own nurses. They do the IVs on the patients. They do the sedation with the anesthesiologist, the doctors, the, you know, it's, it's just like they have their own section back there. Everything's great. The radiologist protocol, each individual child's MRI scans. So there's not just like in the adults, we have abdomen, livers are done this way. Um, Per perfusions are done this way. Like there's, like, in children's, it's specific to each child because their bodies are so different. Uh, they got different things going on, but it was just amazing. I, I learned a lot. I saw a lot at Children's. It was just a whole different ballgame. And when it came to MRI safety, everything was safe. Like everything you had double checks on and a lot of stuff. But when a mistake did happen, Um, it was at least in this particular mistake, nothing was, that anybody did was particularly off. It was just one of those freak things like Dr. Wore a lab coat and there's an instrument they used to remove foreign objects from children's nose is pretty much that's what this was. And it was so, it wasn't huge. And she went through the metal detector cuz the door has a metal detector. Went through the metal detector, didn't pick it up. She checked her pockets before she went in. I mean, that was something you just do. I don't know. If you work an mri, you work around mri, you're always patting yourself down, you're always patting yourself down before you, I still do it before I walk in. Even when I walk in the rooms to have the metal detectors around the door, I'm always like, let me hit my pockets. Let me make sure. And I walked in so many times with my debit card, especially at the lunch or my credit card at lunch, and the strip is, the stripe is erased. You know, the strippers erased. So, I'm used to pat or my keys. I walked in one time, my little key bob in my purse, in my pocket. I'm like, oh my goodness. I never walk in with pens. But those are the two main things I've walked in with in my pocket. So just as a habit, I always pat myself down. And this doctor did I, I walked in with her. She did the same thing. Neither one of us buzzed off and. We usually raised the patient up, but we decided not to. I don't know. I, I'm just so grateful. We didn't do our normal routine. We got close to the scanner, patient sedated this little thing, comes flying outta her pocket, straight in, boom, to the scanner, and we both looked, she almost collapsed to the floor. I mean, it was so fast and so quick, and there was nothing that was done that wasn't, you know, double checked. So that's why I say, You gotta be extremely careful because things happen. But if you have the steps and the um, systems in place, you know, it allows for things to, things are gonna happen, they're gonna happen. But when you follow the systems and follow the safety protocols, you know, you know you did not intentionally harm anyone. And that is the difference. If we don't change every patient, if we don't do safety forms, that's intentional. You gotta do the safety part as a technologist, no matter if the patient is giving you a hard time because they're tired of filling this out, I get all the time people write on a, on a surgery. If you have surgeries, we want you to list your surgeries. See my chart? I don't have your chart. You know, and, and, and we're, we're not able to look in your chart like that. We need you to fill this out because if someone went back to it, say they're not gonna be able to go to your chart. We need to know right then, uh, what is in it. So I personally don't scan people who write, see my chart. You have to fill it out. I give it back to you to fill it out. If you don't wanna fill it out, I don't scan you. That is the policy. That is the rule. MRI safety is for a reason. And as technologists, if we. Choose when we want to employ it. It makes it harder. For the patient to really understand that we're trying to protect them. So I'm gonna be doing a series since this week is MRI safety week. I'm gonna be talking about more. I'm gonna be talking when it comes to contrast. Um, different types of form bodies, uh, risk and identification markers. Um, Different areas we mainly are focusing on to keep you safe when it comes to your MRI scan. So definitely tune back in this week. We're gonna have great conversations. I would love for you guys to, uh, let me know when I post this. What did you like, what questions do you have when it comes Tom? MRI safety, because MRI scans are definitely amazing and they're great for diagnosing and helping pa. And helping patients to see what is going on in their bodies and to get a conclusive, detailed answer. But of course we have to make sure we employ safety measures, and I feel educating people on MRI safety is key. So thank you for tuning in to this episode and check us out this week. Again, happy m r I Safety week.