Our company, Mednovus, is making the annual pilgrimage to Chicago after Thanksgiving for the biggest of all radiology trade shows, the Radiological Society of North America (RSNA) annual meeting. In my original post I indicated why I thought MRI safety would be a ‘hot topic’ at this year’s RSNA, and gave an itinerary for the North Hall (the Philips Hall) for stops at relevant vendors, including our company, Mednovus (booth #7801). Then I followed up with an itinerary for the Lakeside Center, and just a couple days ago, I provided half of the South Hall.

Continuing on that theme, and to facilitate your review of MRI safety products and vendors, I’d like to suggest an itinerary for visiting the remaining select group of exhibitors from Exhibit Hall A, the South Hall, where the GE mega-booth is located…

The South Exhibit Hall (Hall A) includes exhibitors with booth numbers from 2500 – 6632. And while I won’t pretend to know what each exhibitor offers (so, clearly I won’t be able to identify all relevant MR safety products that might be featured at each exhibitor, please forgive any oversights), I would like to provide you with a short-list of stops that I recommend that you make.

Some of these are on my list because I know and recommend their products (look for the •), others are there because they’re new (to me at least) and I’m curious to learn more about them.

5449 Joint Commission – JCAHO is really only just coming into their own with respect to MRI safety. With the Sentinel Event Alert #38 last year, and next year’s code changes… the future promises that they’ll be more than just a paper tiger for MR.

5800 Sentinelle – Interventional MR is one of the real growth opportunities for the industry, and Sentinelle makes one of the most popular breast coil / biopsy products available.

6403 • American College of Radiology – The College’s MR Safety Committee (which I had the privilege to serve) will be coming out with a new joint statement on Gadolinium in the months ahead, and a revised version of the ‘Guidance Document’ in 2010. If you have a chance, thank them for their leading work in this area.

As before, there are likely vendors not on this list because (1) I either forgot or didn’t know about their product offerings, (2) they’re ‘old standby’s’ that I’m already familiar with, or (3) they’re in a different exhibit hall.

Which segues, nicely, into my (repeated) disclaimer that the above list is just for the second half of the South Hall (Hall ‘A’). If you’d like to read my proposed itinerary for the North Hall B, please click here, or if you’d like to read the MR safety stops for the Lakeside Center, please click here, or if you missed my previous post with recommended stops for the first half of the South Hall, please click here.

Now, if I had to say, it really appears to me as if the South Hall, despite its overall size, is pretty darn light on MR safety vendors that I would recommend you visit. Based only on the number of recommendations against the total number of booths in a given hall, you’re better off dedicating your MR safety time to the North Hall, or Lakeside Center.

If you’d like to conduct your own virtual tour of the RSNA exhibit halls, they offer a wonderful interactive floor plan of the exhibit halls online. You can see which booths I failed to mention (and add your suggestions in the comment field, below), or plan your own itinerary for all three Halls.

I will, of course, be doing some duty in the Mednovus booth, 7801 (just inside the North Hall B entrance that is NOT right next to Starbucks), and I hope that you’ll stop in and say ‘hi’ to me or my colleagues. Depending upon how ensconced I get in those conversations, this list may turn out to be a bigger proportion of my RSNA experience than actually getting to the other exhibits!

The new monograph, entitled ‘Designing and Engineering MRI Safety’, is available from ASHE and details are available from their website.

The document describes planning principles for MRI suites, including cryogen safety, access controls, 4-zone screening, and, yes, ferromagnetic detection.

Ferromagnetic Detection: Recommended for use following the clinical and physical screening by the VA, ACR and recently the Joint Commission, ferromagnetic detection screening should be coordinated into the suite design to provide screening for all persons – patients visitors and staff – preparing to enter the MRI scanner room. For optimal performance, ferromagnetic detection systems should be used both for individual screening (i.e. narrow-aperture portal or hand-held patient screeners) and also as pass-through doorway width portals sited prior to the access opening into the scanner room.

– Designing and Engineering MRI Safety

The new ASHE monograph lends its voice to the large – and growing – chorus of professional bodies calling for ferromagnetic pre-screening of all MRI patients.

The two most oft-cited objections to using ferromagnetic detection are (1) that the technology is too new and unproven and that (2) it is too expensive.

To the first, that the technology is unproven, I think that the list of professional and accreditation bodies that have called for ferromagnetic detection pre-screening (the ACR, the Joint Commission, the Veterans Administration, and now, the American Society for Healthcare Engineers), plus the long list of inpatient and outpatient providers that currently use the technology offer a poigniant (and powerful) rebuke to the idea that this is all too new.

To the second, that ferromagnetic detection is somehow too expensive denies the obvious fact that MRI accidents are profoundly more expensive than well-designed protections. Most ferromagnetic detection manufacturers offer risk-weighted cost tables to help MRI providers identify, in dollars, just what their risks of an accident are. The VA just published a report which states that the average MRI projectile accident in the VA Healthcare system costs over $40,000! When you consider that the Mednovus hand-held Target Scanner™ presently costs only $3,000, roughly equivalent to only three hours of operational magnet technical revenue, the notion that ferromagnetic detection is ‘too expensive’ just doesn’t hold water.

It is our hope that the new ASHE monograph on MRI suite safety will help share the elemental planning principles of MRI safety with everyone involved in planning projects, and will ultimately help to improve the safety of MRI for patients and staff alike.

The full presentation was 90 minutes, including an extensive audience Q&A, but I’ve pulled out one particular section that is particularly relevant to our topic at hand, ferromagnetic detection for MRI pre-screening.

The video excerpt below addresses forthcoming changes to the ‘Guidelines for Design and Construction of Health Care Facilities’, a poly-cyllabic mouthful that roughly translated means the healthcare building code, and changes regarding MRI suite design…

As mentioned in the video above, the proposed changes to the healthcare building code are currently open for public review and comment. The proposed language includes references to the ACR 4-zone principles as well as planning for ferromagnetic detection.

If you would like to see, review or even comment upon the proposed changes to the hospital and healthcare provider building code, public comment for the ‘Guidelines’ is open until December 15th, 2008.

What, you’ve only heard it referred to as ‘Autumn‘ before? Well, that’s not terribly surprising. We’re so inundated with honorary days, weeks, and even months, that the season of MRI Safety Planning fails to get its fair share of media time. But here’s why MRI Safety Planning season should be tops on your list right now.

First, while there is a growing awareness of MRI Safety Week, a single week doesn’t really afford the time needed to plan for improvements to MRI safety. Real improvements come from refinements in operations and process, coupled with effective tools and training. That sort of interdisciplinary approach often requires more than a couple days to put together.

Second, MRI Safety Week falls in the middle of summer when budget-wrangling loses the attention-span battle to thoughts of barbecues and coco-butter suntan lotion. It is precisely now, when so many organizations are hammering out their financial priorities for next year’s budget, that MRI safety planning should be in full-swing.

By combining the operations planning with the budgeting, you can reap some real multi-task benefits from these synergistic efforts, and – buoyed by the support of our whole Mednovus organization – I’m here to help you make it as productive as possible.

When making your MRI safety plans, it’s important to know what new criteria are going to be expected of your facility. Accrediting bodies are all looking at MRI safety in a new way, and this is starting with the Joint Commission’s Environment of Care requirements, effective January of 2009.

There is also the flurry of recent MRI safety Best-Practice recommendations from a number of documents, all of which should be part of the Administrator / Technologist library of reference materials. One common element to the Joint Commission’s Sentinel Event Alert #38, the ACR’s Guidance Document for Safe MR Practices, and the recent Veterans Administration MRI Design Guide, is the recommendation for the use of ferromagnetic detection (see below).

While ferromagnetic detection systems can be readily incorporated into both new and operational MRI facilities with minimal muss & fuss, even the most easily-installed and cost-effective systems typically require advanced budgetary planning.

The upshot? Please start thinking today about your planned MRI safety improvements for 2009 and budget accordingly.

Whether you’re considering the newly-released Mednovus Sentinel® GS 2.0 portals (both the 24-inch Patient Sentinel® GS 2.0 and the 48-inch Entry Sentinel® GS 2.0) or our SAFESCAN® hand-held Target Scanner™ (or the optimal combination of both), it would be a privilege to be at your service.

We at Mednovus are delighted to announce our new association with Siemens Medical Solutions, a world leader in MR imaging, and we encourage you to contact your local Siemens sales rep to get product quotes for your budgeting purposes. Alternatively, simply let us know where you are located, and we will put you in touch with the appropriate Mednovus product expert from Siemens’ national accessories division. Contact us soon so that we can arm you with the information you need to secure MRI safety improvements in next year’s budget.

Yes! Please put me in touch with the right Siemens’ accessories product expert!

By reviewing your current MRI safety protocols against published best-practices, and soon-to-be accreditation standards, you can prioritize the areas for improvement in 2009. In many cases, no-cost operational changes will help you achieve your goals, but whether it’s a new MRI-friendly infusion pump, improved signage, or the thrice-recommended ferromagnetic detector, you will probably need to have a few MRI safety line-items in next year’s budget.

Please contact us if we can be of any assistance in helping you with your observances of MRI Safety Planning season.