Children's Hospital MRI's

[umcRN, BSN, RN]

I am just curious to find out what other children's hospital MRI suites/experiences are like. I ask this because ours seems to be TERRIBLE and we have had many serious safety issues going down there. I had to take my critical, intubated newborn down this past weekend and it was a nightmare!

We have to put all our drips onto special MRI compatible pumps/tubing so prior to going down (if we're lucky enough to get enough pumps beforehand) we have to change everything over and get it running on their pumps. If you're not so lucky you have to do that down in the waiting area where there is no ventilator so RT has to bag the entire time. The pumps only run out to the 0.1 decimal so my drips that had been running @ 0.26ml/hr had to be rounded up or down to 0.2 or 0.3. They also don't run dose rates, only ml/hr.

It took us no less than 45 minutes to get her hooked up to the monitor, they do not have infant sized anything! The leads weren't picking up and kept reading a HR of 60 while I with my finger on her brachial tried to get them on her appropriately so they were reading. They also only have the adult type sat probe which on a 2.6kg infant does not work so well. Takes FOREVER to get an appropriate reading on it then has to be taped into place and you hope that it stays on through the scan. Then there was the a-line. My patient had a borderline blood pressure as it was and I did not want a cuff pressure I wanted her a-line working, well we had to go through 3 different monitors to find one that worked.

It is so frustrating! Everyone hates going to MRI and our hospital is doing studies on congenital heart defects/neurological impacts so all pre-op open heart babies have to have a brain MRI. And it's not just difficult on the little ones, we have these issues throughout the hospital. It never seems to be a smooth process and we always end up down there for a min of 3 hours with the majority of that time having to bag the patient (there is a vent for the scan but travel and set up the pts must be bagged).

Not to mention if the patient codes in the scanner you can't resuscitate them in the MRI room but have to pull them out and back into the prep area...though that is probably similar at all places but still scary!

What are your MRI experiences like?

[dreamingofbeing]

I work in MRI at one of our Children's Hospitals and I can tell you we are nothing like that at all. Everything we have is pediatric specific so we have all sizes of equipment from neonate to adult. We only have 2-3 pumps that are MRI safe so if a child is on multiple drips we have to have the resident or Dr. decide which drips are the most important that can't be stopped for any reason. We do our best to get the pumps up to the unit prior to the scan and we switch the pumps over since the floor nurses aren't familiar them. Ours also can do the micro numbers like 0.26 and such. It takes us about 5-10 minutes to get the baby on the table once they hit our department and most of that time is just switching them to MRI safe monitoring components. Our NICU nurses are awesome and usually have the baby papoosed before they come down if they aren't vented and if they are respiratory has already come down and everything is set up and ready to go. As for coding it may seem like a hassle but it is so much safer to have them out of the room. Think about people coming to a code, they aren't thinking about anything else but the patient but if they have anything in their pockets that is magnetic it instantly becomes dangerous, imagine scissors flying at someone for example. You can't just hit a switch and turn of the magnet it actually takes days to do it properly and that still damages the machine.

[umcRN, BSN, RN]

thanks for sharing! It drives me crazy that we do not have appropriate monitoring devices for our neonatal patients in particular. Especially the Sat probe. I had an MRI tech ask me once if I "really needed the sat probe to work?" On my VENTED patient, umm, yes I did actually. You would think at a children's hospital that we would have the appropriate monitoring devices for infants

[dianah, ASN]

I suggest you take these --- your SAFE PATIENT CARE CONCERNS -- politely and well-researched, up the chain of command.

Go to your unit's Charge RN,

the DON,

the Radiology Manager,

RISK MANAGEMENT (!).

Please help bring about the needed changes for your patients. :)