Ferromagnetic detection for pre-MRI screening is disruptive. Not that it slows down your patient throughput (it doesn’t), or that it makes imaging problematic (it doesn’t do that, either), but it does provide an entirely new type of feedback that MR staff and Technologists have never had before. It tells us whether subjects are actually listening to the self-screening instructions we’ve been giving for years. These instruments, more precisely the feedback that they provide, does take a little getting used to. The introduction of ferromagnetic detection is often met with 5 steps towards acceptance…
1. Resistance, or “What the [bleep] is this thing and who’s making me use it?”
One of the first steps in the path to embracing ferromagnetic detection is often resistance. Some MR staffers assume that the presence of a ferromagnetic screener demonstrates an implicit lack of faith in their ability to screen patients. This couldn’t be further from the truth!
The problem with effective patient screening has always been with the patient. At UPMC, where the Technologists work with the MR-safety-minded Dr. Emanuel Kanal, they found that 44% of all patients that had professed to be free of ferromagnetic material were, in fact, just about to walk into the MRI scanner room with some type of ferromagnetic material on them! That’s almost half the patients at one of the most MRI safety conscious sites in the whole world!
Ferromagnetic screening tools aren’t an indication that administration doesn’t have faith in the Techs, they’re protection for the Techs because it’s patient compliance that we don’t have faith in.
In fact, even with ferromagnetic detection we depend on the conscientious screening and observation of patients by skilled MR Technologists. No technology, not even ferromagnetic detection, is 100% foolproof, but this additional layer of protection has helped Techs to find threats that would have otherwise slipped past.
2 Annoyance, or “Why the [bleep] is this thing alarming on these subjects?”
One of the first thing that sites that ‘plug in’ ferromagnetic detection into their existing protocols find is just how poor patient compliance really is! We thought we did a great job of getting patients to follow our instructions… that is until there was a tool that could actually help measure patient compliance. Without that alarm, the person would more than likely have sauntered into the MR scanner room with whatever we didn’t know about in their pocket. Often, the bits of ferromagnetic-contraband that patients sneak in with wouldn’t cause any harm and can be rationalized-away, but that’s not always the case. Sometimes what get’s missed in conventional screening and access protocols is big, ugly, and scary…
3. Utter surprise, or “How the [bleep] did that get past screening!?”
This might not happen for the first hundred or more patients, but sooner or later you’re likely to be stunned by something identified by the detector that would have been very dangerous if it made it into the scanner room.
What sorts of things? Toolboxes, conventional wheelchairs, steel IV poles, medication pumps, knives, weights, gas cylinders, and the list goes on, and on… These are precisely the sorts of things that ferromagnetic detectors find at facilities across the country. They’re the things that aren’t supposed to be there in the first place, or, if they are there, are supposed to be immediately ID’d by the staff and kept way-far away from the magnet room. But all procedures break down at some point, and the maintenance contractor, or the new person in transport, may not know about your policies.
4. Gratitude, or “Thank goodness this got found!”
It only takes one or two rude awakenings to things that were about to enter the magnet room to change one’s entire outlook on ferromagnetic detection. Imagine the potential damage from that found oxygen cylinder, or the injury that might have resulted from the non-MR infusion pump that nearly made it into the room, and all of the sudden any alerts from the detector become music to Technologists’ ears because they’re the warning for the accident that hasn’t yet happened (and may now, for the first time, be caught before it does).
5. Reliance, or “I couldn’t imagine not doing this for a patient now.”
Some people are unduly concerned about MR staffers jumping right to this final stage and that the Techs will think that ferromagnetic detection technology is going to absolve them of of patient screening responsibility. Personally, I’ve seen many ferromagnetic detection installations and have yet to witness anything like this. The greater concern is that sites give-up trying before step 3 and fail to realize the tremendous benefits to patient safety that ferromagnetic detection provides.
We have clients who tell us about what their SAFESCAN® detector has found on ‘cleared’ patients, or on doctors or nurses who have come down from the floors with a patient. If you found the objects that many of our clients have found (and they generally tend to run top-notch MRI centers, so it’s not as if they need ferromagnetic detection more than anyone else), you’d be instantly convinced of the value, too.
It is worth noting that no technology is 100% foolproof, not even ferromagnetic detection. It’s a tool, and a tremendously helpful one at that, but it has limitations. But just because it can’t do everything isn’t a reason to not use it.
If you’re blindfolded at the edge of a cliff, you don’t know how much that first wrong-step is going to hurt, and hurt badly. And if you don’t know what patients and staff have been carrying into the MRI suite, risking their lives (and perhaps yours), you have no reason to be concerned. But as soon as you begin quantifying how much dangerous material is trying to get into your MRI room, you, like our clients, will never again want to go without the protection of a ferromagnetic screening!Tobias Gilk, President & MRI Safety Director Mednovus, Inc. Tobias.Gilk@Mednovus.com www.MEDNOVUS.com