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…
Nearly all MRI accidents that wind up the subject of civil lawsuits conclude the same way… in confidential settlement protected by a non-disclosure agreement (NDA). This makes it extremely difficult to get to the facts associated with any particular accident. Currently the highest profile MRI accident (the death of a young boy from a flying oxygen cylinder) is in pre-trial litigation and is our best window into the legal responsibility of Technologists and providers. Today, however, I learned of another suit in which a Tech is suing her former employer for willfully putting off needed system repairs that compromised image quality and diagnostic value.
The new ASHE publication, Designing and Engineering MRI Safety, has now been made available for purchase from the American Society for Healthcare Engineering’s website.
With around 8,000 – 10,000 MRI’s in the US alone, I’m not naive enough to think that we can wholly reshape behavior in all, or even a majority, of MRI providers in a single year. I do believe, however, that we can set a realistic goal to improve MRI safety.
I have a serial weakness for medical dramas. I get sucked-in and watch for a couple of seasons before the absurdity catches up with me. With respect to MRI, it seems that 99% of the time the shows are so wildly off-base that it seems that each must outdo its own crazy scenarios (and those of the other medical dramas) to come up with a new MRI-related plot gimmick.
But then, typically after I’ve lost all hope of seeing anything that approaches reality, something plausible and even downright real is shown on one of these programs…
How I long to be judged for my content… my substance… and not just how I look!
No, not me, the author, but the figurative ‘me‘, this blog…
I don’t know if you’ve ever used them, but all of the major internet search engines have tools that you can use to find images that match your search criteria. Every so often there’s a new paparazzi picture of some starlet in mid-wardrobe-malfunction or a politician with a facial expression that looks like they just smelled something awful that become the ‘it’ picture of the day.
Well, based on the number of hits our blog has been getting recently, and the image search tools that many of these hits are coming from, apparently we have a lesser ‘it’ picture, and it has nothing to do with politics or racy nudity…
It’s a picture of an ICU bed stuck to the face of an MRI.
Pictures of things stuck to magnets often generate wide-eyed looks, even laughter. After all, the juxtaposition can be pretty silly. But each of these pictures is only possible because of horrible mishaps that can each result in serious injury, or even fatality.
We encourage people to find and view these pictures, not to have a larger number of viewers snicker at them. We put them up to help deflate the ‘that could never happen here’ mythology that is dangerous. If you can see magnets, floor polishers, oxygen cylinders, wheelchairs or, as above, ICU beds that look like ones in use at the hospital or imaging center, then maybe the internal monologue becomes something more like, ‘what would have to happen here for us to have a similar accident?’
Most importantly, we hope that all of these efforts work to motivate Technologists, Radiographers, Imaging Managers, Radiologists, Risk-Managers and Compliance Officers to imagine which steps they could take at their locations to reduce the likelihood of these sorts of accidents.
There are many steps that can be taken to help improve the effectiveness of pre-screening for magnet hazards. One of the most obvious is also one of the easiest, the use of ferromagnetic detectors.
We encourage you to view and share the information contained on these pages and we hope that each of these resources, even the racy pictures of MRI missile accidents, help shape improvements to MRI safety at your facilities.
After all, I’m lot more than just a pretty face…Tobias Gilk, President & MRI Safety Director Mednovus, Inc. Tobias.Gilk@Mednovus.com www.MEDNOVUS.com
Change is often difficult, especially when we’re asked to change the ways in which we do things and the change doesn’t appear to have any direct, personal benefit.
‘Employees will be required to park in “Lot K” beginning on September 1st.’
‘The company has switched health insurance providers and you will receive your new card in the mail in 4 – 6 weeks.’
‘All persons entering the MRI scanner room must successfully clear a ferromagnetic screening.’
Except that sometimes, things that don’t appear to be in our best interests in fact are to our personal benefit, and ferromagnetic detection is one of them.
First, let’s dispel the myth that ferromagnetic detection is somehow there to ‘grade’ the screening effectiveness of the Technologist. The fact is that most of the time when ferromagnetic material makes it through the screening process it is because the person bringing it failed to comply with instructions that they’d been given!
Yes, there are differences among Technologists and some are more thorough than others, going beyond the standard screening forms. But time and time again we find that projectile accidents are compliance lapses on the part of patients, visitors, contractors, transport, housekeeping, anesthesiology and the myriad of others who come to the MRI suite.
If you had a tool to verify that patients complied with your critical safety instructions, wouldn’t you want to use it?
So, ferromagnetic detection is – first and foremost – present to make sure that patients, staff and visitors comply with the MR Technologist’s instruction. An alarm on your ferromagnetic detector should be viewed as a patient compliance issue.
Second, ferromagnetic detectors help to protect Technologists (and medical directors, and radiology administrators) from liability. The civil lawsuit resulting from the death of the young boy in a 2001 MRI accident personally names the two Technologists and the medical director for the MRI provider. Even if they aren’t found to have any individual civil liability in the trial, they’ve already had a multi-million dollar lawsuit hanging over their heads for the last 6 years or so.
While the presence of a ferromagnetic detector won’t transform an MRI provider into a guaranteed accident-free site, when used effectively these instruments can dramatically improve compliance with the Technologist’s instructions and help reduce the likelihood of future ferromagnetic projectile / missile accidents.
Maybe there’s a silver lining to having to walk the extra two blocks from the newly designated employee parking lot or switching healthcare insurance companies (then again, maybe there isn’t), but there should be no question that ferromagnetic detectors are definitely in the best interests of Technologists, radiology administrators, and MRI medical directors.Tobias Gilk, President & MRI Safety Director Mednovus, Inc. Tobias.Gilk@Mednovus.com www.MEDNOVUS.com