Local cOinage and Hospital Equipment Index (Lo Hei): projectile distance of Singapore coinage and healthcare-related equipment in a 3T magnetic resonance imaging scanner.

INTRODUCTION: Modern magnetic resonance imaging (MRI) scanners utilise superconducting magnets that are permanently active. Patients and healthcare professionals have been known to unintentionally introduce ferromagnetic objects into the scanning room. In this study, we evaluated the projectile risk of Singapore coinage as well as some common healthcare equipment within a 3 T MRI scanner. METHODS: A rig termed 'Object eNtry Guidance and Linear Acceleration Instrument' (ONG LAI) was custom-built to facilitate safe trajectory of the putative ferromagnetic objects. A ballistic gel target was utilised as a human tissue surrogate to estimate tissue penetration. The point at which objects would self-propel towards the scanner was named 'Huge Unintended Acceleration Towards Actual Harm (HUAT AH)'. RESULTS: Singapore third-series coins (10-cent to 1-dollar coins) are highly ferromagnetic and would accelerate towards the MRI scanner from more than one metre away. Cannulas with their needles are ferromagnetic and would self-propel towards the scanner from a distance of 20 cm. Standard surgical masks are ferromagnetic and may lose their sealing efficacy when they are worn too close to the magnet. Among the tested objects, a can of pineapple drink (Lee Pineapple Juice) had the highest HUAT AH at a distance of more than 1.5 m. CONCLUSION: Some local coinage and commonly found objects within a healthcare setting demonstrate ferromagnetic activity with projectile potential from a distance of more than 1 m. Patients and healthcare professionals should be cognisant of the risk associated with introducing these objects into the MRI scanning room.

Common Healthcare Related Instruments Subjected To Magnetic Attraction Study (CHRISTMAS): prospective in situ experimental study.

OBJECTIVE: To investigate the behaviour of common healthcare related objects in a 3 tesla (T) MRI (magnetic resonance imaging) scanner, examining their ability to self-propel towards the scanner bore and their potential for tissue penetration. DESIGN: Prospective in situ experimental study. SETTING: Clinical 3 T MRI scanner. Customised rig designed and built to guide objects towards the scanner bore. PARTICIPANTS: 12 categories of objects commonly found in hospitals, or on patients or healthcare professionals, or near an MRI scanning room. Human tissue penetration simulated with ballistic gel (Federal Bureau of Investigation and North Atlantic Treaty Organisation graded). MAIN OUTCOME MEASURES: SANTA (site where applied newtonian mechanics triggers acceleration) measurements and depth of tissue penetration of the objects. RESULTS: SANTA measurements ranged from 0 cm for the 20 pence, 50 pence, and £2 coins to 152-161 cm for a knife and the biscuit tins. One penny, two pence, five pence, and 10 pence coins showed self-propulsion and acceleration towards the scanner bore at a distance >100 cm from the gantry entry point. Linear regression analysis showed no apparent correlation between the weight of the objects and their SANTA measurements (R2<0.1). Only five objects penetrated the ballistic gel (simulated human tissue). The deepest penetration was by the knife (5.5 cm), closely followed by the teaspoon (5.0 cm), fork (4.0 cm), spoon (3.5 cm), and a 10 pence coin (0.5 cm). Although the biscuit tins did not penetrate the simulated human tissue, they exerted substantial impact force which could potentially cause bone fractures. A smartphone, digital thermometer, metallic credit card, and pen torch remained fully functional after several passes into the MRI scanner. No discernible loss of image quality for the MRI scanner after the experiments was found. CONCLUSIONS: The study highlights the potential for harm (major tissue damage and bone fractures) when commonly found objects in a healthcare setting are unintentionally brought into the MRI scanner room. Patients and healthcare professionals need to be aware of the dangers associated with bringing ferromagnetic objects into the MRI environment.

The effectiveness of collaborative teaching in an introductory online radiology session for master of nursing students.

AIM: The study aimed to evaluate the effectiveness of the collaborative teaching of a multi- disciplinary team on the introductory online radiology session for the Master of Nursing students. BACKGROUND: The teaching method for basic radiology reading for the Master of Nursing program was delivered via a 4-hour didactic face-to-face lesson and was ineffective as evidenced by the students' feedback and evaluation. Therefore, a multi-disciplinary team consisting of nursing, medical and radiology staff developed a 4-week online radiology session to enhance knowledge, attitudes and confidence of the Master of Nursing students in interpreting basic chest radiographs, abdominal radiographs and computed tomographic brain scans. METHODS: A quasi-experimental study design using pre-test and post-test was adopted. The effectiveness of the online radiology session was evaluated on the students' knowledge, attitudes, and confidence. Forty Master of Nursing program students completed the pre-test and post-test questionnaires (response rate 74%) and responded to the open-ended questions in the post-test. IBM-SPSS was used to analyse the quantitative data and quantifying qualitative data technique was used to analyse the qualitative data. RESULTS: The participants demonstrated an improvement in knowledge and confidence mean scores of the post-test compared to pre-test. There was improved self-rated proficiency in reading and interpreting a film radiograph but no difference in the way they perceived the importance of radiological investigations vis-à-vis the physical examination and routine laboratory testing. Quantifying quantitative data technique showed that majority of participants appreciated the learning process as it could be done at their own pace and the lectures could be replayed again. However, participants hoped for improved interaction with the tutor during learning and the use of real-life cases in the scenarios. CONCLUSION: Collaborative teaching using an online radiology session shows promise over a traditional didactic method of teaching but requires further refinement in terms of participant interaction and the use of case examples.