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When small is big: MR safety for pediatric patients

March 16, 2021
MRI Pediatrics
From the March 2021 issue of HealthCare Business News magazine

Pediatric MR providers have emerged as one of the best “proving grounds” of MR safety best practices. This involves identifying effective best practice standards, and then a process of adoption and adaptation to where the practices and specific workflows are integrated. “It’s not copy and paste,” offers Bushur. “Every site is very different, and what works for us and what works for another children’s facility might be two entirely different processes, depending on what their workflows are.”

Bushur’s statements highlight a truth about safety practices, in general, and MR safety, in particular: they typically need to be translated from aspirational standard guidance to practical implementation, and that translation process requires thought and care to enable consistent and effective outcomes. Even beginning with widely respected standards, such as the ACR Manual on MR Safety, the “devil is in the details”, and a brilliant standard that is poorly integrated will not be expected to produce reliable results.

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As for why pediatric MR providers are willing to put in this additional work (and are often regarded as more committed to MR safety), Bushur believes, “all patients are important, but I feel pediatric patients have a special place in people’s hearts and you take extra care because you’re not only treating the patient, but you’re also treating their family. It’s not just one little human, it’s the whole family that you’re taking care of when you take care of that patient.” In short, the stakes are higher. Based on reports from her techs who also take PRN work in general hospitals and imaging centers, “MR safety really isn’t taken to the level that we take it in the pediatric world.”

For this year, 2021, the anniversary of the MR death of Michael Colombini and a year dedicated to reflecting on MR safety, little could be more appropriate than to emulate the care and effort that children’s hospitals put into MR safety.

About the author: Tobias Gilk is an architect with RAD-Planning, and founded his own consulting firm, Gilk Radiology Consultants. He is both certified MRSO and MRSE, and is a board member and former chair of the American Board of Magnetic Resonance Safety (ABMRS).

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Steven Ford

MRI safety

March 25, 2021 02:35


A lot of people would be interested to know the circumstances of the tragic death you refer to, so we can take appropriate countermeasures.

The existing requirements for 'Zone 1', 'Zone 2' labeling in the MRI suite are less than ideal in my opinion because the meaning of those terms is not immediately and intuitively obvious. A Zone 1 sign in the waiting room does not change anyone's behavior.
Better to have signage that is more obvious, more in-your-face, even if that is at the expense of 10% accuracy. Better to require floor markings as well as impossible-to-ignore physical barriers. Better to restrict access inside the MRI room even to hospital staff who have not undergone specific MRI training, including doctors. In my experience, doctors are the chief violators of magnet safety protocols.

Another common real-world safety weakness is that some MRI suites are not locked in off-hours.

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