MRI Safety Still a Concern, But National Guidance Lacking
Published on the July 27, 2012, DiagnosticImaging.com website
By Whitney L.J. Howell
Last October, the U.S. Food and Drug Administration (FDA) held a meeting to examine the biggest MRI safety concerns and outline best practices to reduce injuries associated with the scans. So far, however, the industry has received no national guidance on how to accomplish this goal.
But the lack of official instruction at the federal level doesn’t mean the push toward greater MRI safety — being recognized this week during MRI Safety Week — has stalled. Advancements are underway at the state level and in the accreditation process to prevent another tragedy, such as the 2001 Colombini case when a 6-year-old boy died when an oxygen tank flew across the room and struck him during the imaging process.
“Any protection that is implemented will benefit the 30 million Americans who get MRIs on an annual basis,” said Tobias Gilk, president and MRI safety director at Mednovus and senior vice president at the design and architecture firm Rad-Planning. “People are beginning to look harder at MRI risk factors as the power of our magnets continue to increase.”
State Regulations
Many states and the Joint Commission have implemented new regulations that strictly govern the design and construction of new MRI suites. These requirements do not mandate retrofitting existing installations.
“There are a growing number of states that are adopting this building code,” Gilk said. “Anyone who does MRI suite work — renovation, upgrade, equipment replacements, anything with a building permit — in virtually every jurisdiction must follow these state standards.”
To conform to the building regulations, health care engineers must meet eight standards, Gilk said. They must follow the American College of Radiology’s (ACR) 4-Zone Principles that addresse integrated access controls and screening practices. There must also be a clear line-of-sight between the operator’s console and patient inside the MRI machine, and designers must include demarcation lines to keep individuals with implantable medical devices far enough away. The presence of ferromagnetic-only detectors is required, and new MRI suites must also have exhaust fans and other protective measures to eliminate any cryogen that escapes into the imaging area.They must include an always-illuminated sign to remind staff that the MRI magnetic field is always active even without a patient.
These new design codes also require a clearly marked safe zone in which staff can use MR conditional equipment. Most importantly, Gilk said, designers and engineers must remember there is no cookie-cutter model for MRI suites. Each site is different and requires individual planning.
Accreditation
In a switch from years past, Gilk said, the Joint Commission is requiring far more documentation to prove you are making your MRI suite as safe as possible for patients. As part of the ACR’s 4-Zone Principles, the Commission now requires proof that you have established access control and provide proper staff supervision. You must also produce documentation that you have adequately trained your MRI personnel in safety procedures and protocols, he said.
“The Joint Commission wants to see evidence of screening protocols for implants and devices, clinical contraindications, and physical screenings,” Gilk said. “They want to see what you’re doing to make sure visitors aren’t carrying objects that will become dangers in the magnet room and what processes or tools are in place that accidents don’t occur.”
Requiring these measures — from an accreditation standpoint — is a giant step forward, he said.
To read the remainder of the story at its original location: http://www.diagnosticimaging.com/mri/content/article/113619/2092918
Telemammography Taking Hold
Published on the Jan. 24, 2012, DiagnosticImaging.com website
By Whitney L.J. Howell
Over the past decade, the field of mammography has become a paradox. Leading medical organizations disagree about the benefits of the study and the best age for a baseline exam, but the number of scans is rising. At the same time, the number of facilities and radiologists willing to read these studies is falling.
As of January 1, according to the American College of Radiology, there were 8,125 accredited mammography facilities nationwide, down from 9,400 in 2000. Many in the industry have turned to telemammography as the best way ensure patients still have access to screening and diagnostic scans. The number of companies offering telemammography is still small, but the group is growing.
“The potential for telemammography is huge — women over 40 will need to have their mammograms,” said Timothy Myers, MD, a reading radiologist with teleradiology company vRad. “The issue, however, is there just aren’t a lot of players. Teleradiology is just now coming to an age where it’s easy to transfer images.”
As part of its teleradiology services, vRad also offers telemammography.
The premise behind telemammography is the same as general teleradiology — a radiologist reads the studies at a location other than the clinical setting of service. Today, most telemammographers are compliant with the Mammography Quality Standards Act and are licensed in both their states of residence and practice. This strategy does have specific hardware requirements unique to mammography, however, including mega-pixel computers that provide a high degree of image clarity for both sending and receiving providers.
Although there is some disagreement between industry experts and practitioners about whether telemammography is equally as useful for screening and diagnostic mammograms, overall the strategy has received a warm — if slow — reception.
To read the remainder of the article: http://www.diagnosticimaging.com/teleradiology/content/article/113619/2021608
Ergonomic Designs Make Imaging Workstations More Comfortable
Published on the Oct. 4, 2011, DiagnosticImaging.com website
By Whitney L.J. Howell
Aching hands and a sore back are familiar ailments for many of those working in a digital imaging department. However, there is a trend among radiology practices and hospitals to provide workstations that are far more comfortable.
Over the past few years, industry vendors have taken great pains to produce ergonomically designed imaging tables and chairs and workstations. The goal is easing the physical stress of repetitive motions associated with
performing and reviewing imaging tests, as well as chronic conditions such as carpal tunnel syndrome and tendonitis.
“There are some sonographers who suffer career-ending injuries because they don’t have comfortable workstations,” said Richard Schubert, product manager of imaging tables at design company Biodex.
In a 2008 study published in the Journal of the American College of Radiology, Phillip Boiselle, MD, reported 58 percent of radiologists at Beth Israel Deaconess Medical Center experienced repetitive stress injury symptoms associated with their work. The study also determined 70 percent saw symptom improvements after using an ergonomic chair, and 80 percent had the same experience after switching to an ergonomic workstation.
“Repetitive stress symptoms are highly prevalent among radiologists working in a PACS-based environment but are responsive to ergonomic interventions,” Boiselle and his colleagues wrote. “Radiology departments should implement ergonomic initiatives to reduce the risk for repetitive stress injuries.”
To read the remainder of the article: http://www.diagnosticimaging.com/practice-management/content/article/113619/1962878
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