MR Imaging Safety: Siting and Zoning Considerations.

Although comparatively much younger as a discipline, these early decades of the structure of practice of MR imaging safety have developed in an alarmingly ad hoc manner, particularly when contrasted with contemporary ionizing radiation safety. This absence of structure and metrics for MR imaging safety has impaired the direct safety best practices for the recognizable domains of clinical and operational MR safety. If the built environment of MR imaging is effectively the hardware of the mechanism of health care delivery, then the appropriateness of this hardware to the software (clinical and operational practices) is of great importance.

ACR guidance document on MR safe practices: Updates and critical information 2019.

The need for a guidance document on MR safe practices arose from a growing awareness of the MR environment's potential risks and adverse event reports involving patients, equipment, and personnel. Initially published in 2002, the American College of Radiology White Paper on MR Safety established de facto industry standards for safe and responsible practices in clinical and research MR environments. The most recent version addresses new sources of risk of adverse events, increases awareness of dynamic MR environments, and recommends that those responsible for MR medical director safety undergo annual MR safety training. With regular updates to these guidelines, the latest MR safety concerns can be accounted for to ensure a safer MR environment where dangers are minimized. Level of Evidence: 1 Technical Efficacy Stage: 5 J. Magn. Reson. Imaging 2020;51:331-338.

Safety Considerations of 7-T MRI in Clinical Practice.

Although 7-T MRI has recently received approval for use in clinical patient care, there are distinct safety issues associated with this relatively high magnetic field. Forces on metallic implants and radiofrequency power deposition and heating are safety considerations at 7 T. Patient bioeffects such as vertigo, dizziness, false feelings of motion, nausea, nystagmus, magnetophosphenes, and electrogustatory effects are more common and potentially more pronounced at 7 T than at lower field strengths. Herein the authors review safety issues associated with 7-T MRI. The rationale for safety concerns at this field strength are discussed as well as potential approaches to mitigate risk to patients and health care professionals.

Planning an MR suite: What can be done to enhance safety?

Magnetic resonance imaging (MRI), frequently touted as the "the safe modality," suffers from significant, and growing, numbers of preventable adverse events. Improvements in MR safety can result from enhancements to expected operational elements: training, screening, and patient-management protocols. Less frequently considered is the safety benefits that may be realized through smart design of MR facilities. Through conscientious and thorough prospective site planning involving MR staff and radiologists in the design process for MR physical facilities, MR providers can have a positive impact on improving safety as well as efficiency for the benefit of their patients, for ancillary healthcare workers, and for themselves.

Interrelating sentinel event alert #38 with the ACR guidance document on MR safe practices: 2013. An MRI accreditation safety review tool.

When, in 2008, the Joint Commission released its Sentinel Event Alert #38 regarding MRI safety, it joined the ACR's Guidance Document on MR Safe Practices as one of two radiology best-practice documents establishing MR safety protections. However, particularly for MR providers who held both modality-level accreditation from the ACR, and enterprise-level accreditation from the Joint Commission, there has been confusion about which institution's standard takes precedence, or whether there are inherent conflicts between the two. With the release of the 2013 update to the ACR Guidance Document on MR Safe Practices, the authors have cross-referenced the performance criteria of both MR safety standards, and correlated the ACR Guidance Document performance criteria with the Joint Commission's Environment of Care standards.

Emergency preparedness for imaging service providers.

While the images of Hurricane Katrina are still vivid, it is important to draw from them the lessons that can be applied to protect patient care services in the event of other disasters. It is important that healthcare providers anticipate the possibility of these events and plan accordingly. A comprehensive plan involves preparation for a disaster, prioritization of the community's immediate needs to restore critical patient care services first, and prevention of future event impacts. A number of considerations should serve as a starting point for conversations regarding a facility's emergency preparedness plan. These involve identifying potential natural and man-made disasters, utility interruptions, equipment damage, patient transportation, case prioritization, and potential outside resources. Some important points to remember when preparing for substantial wind and flood damage: Follow original equipment manufacturer (OEM) recommendations regarding preemptive equipment power-down/ramp-down,particularly for concerns about storm quenches. For magnetic resonance imaging (MRI) scanners left running, to p off cryogens, if possible. Cover all non-removable equipment with taped-down heavy plastic sheeting to protect against roof failures/leaks. Raise all electronic equipment and emergency response supplies as high off the floor as safely possible to protect against flooding. Provide adequate food and potable water for staff/patients that cannot be evacuated. Prior to the storm, contact vendors to secure options imaging equipment, portable generators, and cryogen service after the storm passes. If power is lost, restore power to the MRI cold-head as quickly as possible.