As a CCU nurse, you are likely familiar with sending patients for various diagnostic imaging tests. Magnetic resonance imaging (MRI) is a crucial tool for examining internal organs, bones, and soft tissues. While non-invasive and painless, MRIs require specific precautions due to the powerful magnetic fields involved.
Here is a breakdown of what you need to know about preparing CCU patients for MRI scans.
Patient Assessment and Screening
Before an MRI, a thorough patient assessment is crucial. This is what you should look for.
Absolute Contraindications: Certain implanted devices like pacemakers, vagus nerve stimulators, and some cochlear implants cannot be exposed to the strong magnetic field. Similarly, internal metal objects like shrapnel, surgical clips, and metal mesh pose a safety risk.
Life Support: If the patient requires life support equipment, coordinate with the MRI staff beforehand to ensure compatible equipment is available outside the scan room.
Informed Consent: Verify that the patient has signed the informed consent form for the MRI.
Scanner Compatibility: Confirm with the MRI department if their scanner can accommodate the patient’s size and weight.
Allergies: Note any allergies the patient might have, which might be relevant during contrast administration.
Claustrophobia: Some patients experience anxiety in enclosed spaces. Discuss visualization techniques or relaxation strategies with them. Consider medication or open MRI options for severe cases.
Patient Education and Preparation
Educate the patient and their family about what to expect during the MRI:
Painless Procedure: MRIs do not cause pain, unlike some other imaging techniques.
No Radiation: Explain that MRIs utilize radio waves instead of ionizing radiation like X-rays.
Fasting (Optional): Fasting is generally not required unless the scan focuses on the abdomen or pelvis.
Importance of Stillness: Emphasize the need for the patient to remain still during the scan to ensure image quality.
Loud Noises: Warn the patient that the MRI scanner can generate loud noises. Earplugs or headphones will be provided to minimize discomfort.
Nerve Stimulation: Let them know they might experience a tingling sensation due to the magnetic field.
Communication Available: Reassure the patient that they can communicate with the technician throughout the scan using a call button if needed.
Scan Duration: Scans typically last 30 to 90 minutes.
Cost: MRIs can be more expensive than X-rays or CT scans.
Additional Considerations
Contrast Agents: If contrast medium is required, typically containing gadolinium, an IV will be inserted beforehand. Patients with severe kidney disease might be at risk for a rare condition called nephrogenic systemic fibrosis with certain contrast agents. Dialysis patients require special considerations for contrast use.
Metal Objects: Remove all metal objects from the patient, including jewellery, piercings, eyeglasses, and transdermal medication patches containing metal.
Pregnancy: MRI scans are generally avoided during pregnancy, particularly the first trimester.
By following these steps and effectively communicating with the patient and MRI staff, you can ensure a safe and successful MRI experience for your CCU patients. Remember, clear communication and meticulous preparation are key to a smooth and successful MRI scan.
