Patient care week 9

Patient Screening and Safety

• Patients may not fully understand their medical history, leading to inaccurate information.

  • Example: A patient with L4-L5 fusion only reported having sutures.

• Emphasize patient education about MRI procedures and contraindications.

• Liaisons from medical imaging offices could educate other doctor's offices.

• Patients often confuse CT and MRI.

  • Example: A patient with brain coils scheduled for an MRI had only undergone CT scans.

• Never take a patient's word for their history; always verify.

• Even doctors may not know the difference between CT and MRI.

• Patients may have unrealistic expectations about MRI procedures.

  • Example: A patient was told there would be no noise during the scan and panicked when it was loud.

• Scheduling staff should be educated about all modalities in their facility.

• Patients may not realize the differences between 1.5 Tesla and 3 Tesla MRI machines.

• Sites have different standards regarding clothing and implants.

• Over-caution and standardization are crucial.

Global Health and MRI Standards

• A patient from India with a prior skull surgery had staples in their head, highlighting the need to verify even old surgeries.

• Most of the world does not have MRI certification.

• Healthcare professionals should aim to share knowledge and education globally.

• AI is unlikely to replace MRI techs due to the complexity and youth of the field.

Handling Difficult Situations

• Approach situations with patience, love, and kindness.

• Patient care is the most important aspect of the job.

• Some MRI techs may lack care, leading to negative patient experiences.

  • Example: A patient was left in the MRI machine with no noise for hours, and only cleaning staff helped them.

  • Example: Patients report not receiving hearing protection or squeeze balls.

• Focus on patient care to be a cut above the rest.

• Critically think through scenarios and slow down when necessary.

• Document stories to improve patient care practices; be better technologists through patient care.

Course Updates and Reminders

• Week 8 homework is being graded.

• Week 9 work is due on June 3rd.

• The Week 9 assignment will focus on cultural diversity in healthcare.

  • Example: Some religions frown upon organ transplants or blood transfusions.

  • Example: Certain cultures have specific requirements for food preparation.

  • Consider how these cultural factors might affect patient care in MRI.

• A lower quiz score was seen due to not reading the chapter assignments.

• The final exam will be opened next Wednesday and there will be a study review.

• Evaluations for Megan and the instructor must be completed before the final opens.

Quiz 8 Review

• To monitor an irregular or slow pulse, use the apex of the heart with a stethoscope due to rhythm issues.

• Tachypnea is when a patient is breathing more than 20 breaths per minute, with a normal adult range of 12 to 20 breaths per minute.

• A blood pressure reading of 140/90 is categorized as stage one hypertension; the normal range is 120/80.

• An MRI order designated stat indicates that the patient's well-being may be jeopardized by a delay in implementing the order.

• If a patient complains of sudden, intense chest pain, assume they are having a heart attack until proven otherwise.

• The safest posture for maintaining the airway of an unconscious, vomiting patient is the lateral position.

Medical Emergencies in MRI

• Contrast reactions are the most common emergency.

• Seizures

  • Rare, but patients with a history of seizures need monitoring.

  • Get the patient on their side and out of the scanner.

  • Do not restrain them or put anything in their mouth.

  • Remove the head coil off during the brain scan so it does not smash their face.

  • Lower the table.

  • Notify the emergency response team.

  • Document time, duration, symptoms, and patient response

• Cardiac Arrest and Codes

  • Signs include chest pain, tightness, and shortness of breath.

  • Call a code blue and get the patient out of the scan room.

  • Begin CPR if they lose consciousness and have no pulse.

  • Prepare the crash cart but do not bring it into the scan room.

Anesthesia in MRI

• Used for pediatric patients or adults with severe claustrophobia.

• MRI-safe anesthesia carts are required.

• Monitoring equipment must be properly set up.

• Never leave a sedated patient unattended during the scan.

• The assignment is a sedated patient is regaining conscioiusness during the scan, what steps to take to ensure stability.

Emergency Equipment and Procedures

• Quick Release

  • Quick release buttons or handles on MRI tables allow for rapid patient extraction in emergencies.

  • Quick release is used to releases the mechanism on the table, so you can just pull

  • It releases the mechanism on the table so that all you have to do is pull it comes out as fast as you can pull.

  • Located at the end of the table and on the side of the Siemens machine.

  • Used for patient vomiting or struggling inside the machine.

• Decommissioned magnet demonstration

  • Metal objects are very dangerous because they stick.

• Quench Button

  • Used only when someone is trapped and in a life-or-death situation.

  • Otherwise, field engineers can ramp down the magnetic field.

  • A spontaneous quench can occur if the helium compressor fails or is damaged.

  • Spontaneous quench is when a compressor is not receiving the water like it is supposed to, building pressure and automatically quenches

• Sealed doors

  • Sealed Doors prevent radio frequency leaking but can delay emergency access.

  • Emergency releases and breaking the window (Faraday cage) are options if the door malfunctions.

  • A broken Faraday cage does not automatically stop the machine.

• Emergency Equipment

  • There are wall oxygen and suction that should be prepared

  • Be aware of emergency meds, such as in Pixus station for administration.

  • Make sure there is an MRI safe fire extinguisher (different color) in the room.

• Natural Disasters

  • If the power goes out at the facility, open the door and release the table, bringing them back to a safe room.

  • Keep scanning if there is an earthquake: FALSE! Get the patient out of the machine.

Documentation

• Record the event, time, and actions taken.

• Document the patient's condition before, during, and after the event.

• Document what the reaction was, how severe it was, and what actions were taken so people are aware the next time they go to scan that patient.

Role During an Emergency

• Recognize the emergency.

• Stay calm.

• Remove the patient from the scanner and zone 4.

• Activate the code or response team.

• Support the healthcare team.

• Maintain communication.

• Document everything