TABLE 572 Emergency Department Patients in the Magnetic Resonance MR Environment

ED personnel as well as their patients must be "cleared" for MR compatibility prior to entering the MR suite. A number of implanted medical devices are not MR compatible. The most common of these are certain brain aneurysm clips, cardiac pacemakers, cochlear implants, and internally placed pumps or electrical stimulators. Regarding brain aneurysm clips, the specific manufacturer of the clip and the model number should be provided to MR department personnel, who can advise on MR compatibility. Patients are also questioned to determine whether they have had injuries or a typical work history that would place them at risk for having metal fragments in or near the orbit or brain. Because of space limitations, all such devices cannot be reviewed in this chapter, and readers are advised to consult with MR personnel for any implanted device or device transported with the patient. Finally, although there is no known biohazard to humans or fetuses at approved energy levels specified by the Food and Drug Administration, pregnant hospital personnel are advised to stay out of the MR suite. Patients who are pregnant are requested to sign a consent form prior to MR imaging. These consent forms state that the potential benefit of the MR test for that patient greatly outweighs the potential risk to the fetus and mother, which appears to be extremely low or negligible (particularly, for example, compared with known risks of ionizing radiation with nuclear imaging studies or computed tomography). Contrast agents used for MRI are contraindicated during pregnancy.

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