So you have to send your patient to MRI…

So your patient needs an MRI. Maybe you can just send them down with transport, maybe you have to come down with them. Here are 10 tidbits to help make it easier or yourself and us.

1. THE MAGNET IS ALWAYS ON. ALWAYS. 
2. Because of #1, don’t bring anything you don’t need on your person. Majority of what you carry is not MRI compatible and you’re going to have to leave it somewhere away from the MRI room anyway.
3. Also, don’t leave anything on your patient that they don’t need. The 4 blankets? Yeah, let’s consolidate that. The SCD’s? Leave those in the room. The stickers from their morning EKG? Take those off, they aren’t MRI safe. No, your patient can’t bring his/her phone with them. Your patient will need to be moved off of the hospital bed and onto the MRI safe stretcher, let’s make this easy on everyone.
4. Coming down with your patient? Understand that you aren’t just going to walk into the MRI room when you get downstairs. You may be in a rush, we aren’t. Safety is our number one priority. We have to make sure you don’t have anything unsafe on you and we have to check the patient for the same reason.
5. ICU nurses please note: your ECG leads and pulse ox are coming off once you get here so be prepared to replace those. We have our own MRI compatible monitoring equipment, your patient will be monitored using our stuff not yours.
6. Take a look at what IV fluids you have hanging, are they necessary? Your IV pump is not compatible with the MRI machine. No, seriously, it’s not. You are probably going to have to add like 30 feet of extension tubing to your drips unless your hospital has the MRI safe pumps and there aren’t many hospitals that have them. Do you really need to bring the patient down on normal saline? Really? Can the TPN and lipids be paused for 30 minutes to an hour? Thinking of this while you are still on the unit is going to make the transition much easier. ICU nurses, take note because we are notorious for bringing down drips that could really be paused for this test. I’m not saying be unsafe to make it easier, just use your judgment.
7. The magnet of the MRI interferes with the ECG monitor, you are NOT going to get a good rhythm while your patient is in the scanner. This, in particular, applies to my ICU nurses. Please understand that there is nothing we can do about that. The monitor is wireless and whenever the magnet begins scanning it disrupts the signal so the rhythm that we see on the monitor is garbage. In between scans you will see a normal rhythm but once the technologist begins the next part of the study you are going to see nothing but artifact. If your patient has been having unstable arrhythmias you may want to speak with your docs about the risk/benefits of coming down for the scan. You may want to wait until you can trust that they aren’t going to jump into some funky heart rhythm during the scan. That MRI of the foot can wait.
8. Pacemakers no longer exclude a patient from having an MRI. It used to be having a pacemaker was an automatic “no”. That has since changed. There are now MRI conditional pacemakers and we are now scanning patients with MRI non-conditional pacemakers. That being said, let your physician know that an MRI on a patient with a pacemaker is NOT going to happen the day it’s ordered. Many steps have to be taken to assure we do this in the safest manner possible. We need paperwork from whatever company manufactured the pacemaker. We then have to set it up so that a technologist from the company can be there to put the pacemaker in “MRI-safe” mode.
9. FYI: MRI safe mode does NOT mean we turn the pacemaker off for the scan! This was something I was not aware off until I became a radiology nurse. It’s the exact opposite. The pacemaker mode is actually changed from pacing only when needed to pacing continuously at a set rate determined by the doctors and set by the technologist from the company.
10. Do not send your patient down if they are claustrophobic, altered, or in pain unless you have a plan. For a successful MRI, the patient MUST lie still for the ENTIRETY of the scan. If they move, that section of the scan must be restarted FROM THE BEGINNING! If you know they are claustrophobic, ask for something to help calm them. If they are altered and can’t hold still, ask for a sedative of some sort or reschedule. If they are in pain, please premedicate them. The MRI table is hard and uncomfortable, your patient won’t be able to tolerate the scan if they are already in pain.

Hopefully these 10 tidbits of info make your trip to MRI a tiny bit easier.