0:00

Welcome to A Couple of Rad Techs Podcast,

0:02

where we bring you an inside look at the world

0:04

of radiology from the unique perspective

0:06

of a married couple of radiologic technologists.

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Together, we have over 30 years of experience

0:12

in the field and are here to demystify

0:14

the science of medical imaging. Radiology

0:16

is the unsung hero of the medical field,

0:18

providing doctors with crucial images

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and information that help diagnose

0:23

and treat illnesses. Join us as we

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explore the latest techniques, technologies,

0:27

and innovations in radiology and discover

0:30

the vital role we play in the healthcare

0:32

industry. So come along for the ride as

0:34

we share our passion for radiology

0:36

as a married couple.

0:38

Welcome everyone to A Couple of Rad Techs

0:40

Podcast. I am your host, Chaundria

0:43

Singleton, and you got all

0:45

this stuff about me because you guys have been here

0:47

on this podcast with me for the last few years,

0:49

and I love having you and I

0:51

brought another wonderful guest today.

0:53

This is actually going to be an MRI topic

0:56

today. So buckle up. Everybody wants

0:58

to become an MRI technologist and

1:00

we want you to become an MRI technologist.

1:03

I am bringing more MRI topics.

1:05

We're going to be talking about something that is a hot topic

1:07

today. MRI safety. We see

1:10

all the videos about wheelchairs

1:12

and oxygen tanks flying into these MRI

1:14

scanners. We have Kellye Mantooth.

1:16

She is a Radiologic Technologist. She

1:19

specializes in MRI. She

1:21

has other specialties that really make

1:23

her an expert when it comes to safety.

1:25

Thank you, Kellye, for being on our podcast

1:27

today.

1:28

Thank you for having me. I'm excited to talk

1:30

about MR safety.

1:31

Give us a brief little synopsis. I

1:33

kind of delved in a little bit about who you are,

1:35

but I want you to do it. You can do it better. Tell

1:38

us who you are.

1:38

I have been an MR. Tech for

1:41

almost 13 years now.

1:44

Aside from being an MR. Tech, I have

1:46

my certification as an MRSO

1:48

and an MRSE. I

1:50

serve on the board for the ISMRT MR

1:52

Safety Committee, and I also serve on

1:54

the board for the ABMRS.

1:56

Nice. We're going to tell everybody what all of those

1:58

acronyms stand for, because

2:00

patients want to know, technologists

2:03

I feel need to know. There are so many things.

2:05

I had a technologist who's been doing radiology

2:07

for like 45 years comment on one of

2:09

my Facebook posts and I'm like, 45

2:12

years. Wow. They're like, I remember

2:14

Ultrasound didn't exist. CT didn't exist.

2:16

That is like the early stages. Now

2:19

we're talking even more. We're looking at the field

2:21

advance even more. You're hearing all these acronyms.

2:24

If you're a technologist in radiology,

2:26

if you're a student in high school and thinking about

2:29

going into our amazing field,

2:31

one of the close to the third largest medical

2:34

professions. Our profession is always

2:36

evolving and technology

2:38

makes that happen. Don't be afraid of technology,

2:41

stick with us. We're going to get right into

2:43

it. You got into the radiology field. You

2:45

said 13 years ago, when did you get into MRI?

2:47

I went through X ray school

2:50

and when I was in X ray school,

2:52

I had a rotation in MR and I knew immediately.

2:55

Once I did my rotation in MR, I was like, this is

2:57

it. This is where I'm going to be. I

2:59

got all of my competencies done pretty

3:01

early on and got to just

3:03

go to MR and do like my, selections

3:05

where you get to select your rotation.

3:07

I did mine. I chose MR and just did

3:10

all of mine there. They offered me a job

3:12

when I was still a student. So I started

3:14

working as a student tech while I was still in X

3:16

ray school. When I got out, I got a job in

3:18

MR. People think about this now, like, oh,

3:20

there are so many job openings, but 13 years

3:22

ago, the market looked very, very different. There weren't

3:25

a lot of job openings back then.

3:27

Yeah, I don't think people realize that. One thing

3:29

I do notice about the field. It is ever

3:31

changing when it comes to jobs. I look at the

3:33

fact that I know X ray techs

3:35

doing diagnostic radiology making 70

3:38

an hour.

3:39

Wow. Yeah, it wasn't like that 13

3:41

years ago.

3:42

It's gonna change. I know people

3:44

that went into other modalities

3:46

and CT techs were making 90, and even

3:48

right now. I remember radiation therapy, there were like

3:50

zero jobs back 20 years

3:52

ago. Everybody was coming back to

3:55

diagnostic X ray because it was flooded

3:57

in radiation therapy. I'm going to kind of talk about

3:59

that because it goes back to my point. You started

4:01

out in radiology technology

4:04

school. That's your bread and butter. That

4:06

gave you your foundation and now look

4:08

where you've been able to go to. What's

4:10

been the most fascinating thing that you've learned

4:12

about MRI safety?

4:14

Oh, my goodness. So many things.

4:16

I think probably the biggest thing that I

4:18

can drive home for people is that all

4:21

of these adverse events that we see on social

4:23

media, any incidents that occur,

4:25

they're all preventable. We just have to have the knowledge

4:28

to be able to prevent them. And I think

4:30

that's what keeps me going. That's what drives me

4:32

every day is saying, how can we get this knowledge out

4:34

there to people so that they can take better care

4:36

of their patients?

4:37

Yeah, that's really important. I love how you

4:39

said, because this is something that I did when I went to

4:41

radiology school. I knew I had two years

4:43

of a program and I kind of

4:45

looked at the curriculum. But I said, I know there's so many

4:48

other things out there. MRI was there.

4:50

CT was there. Ultrasound, radiation

4:52

therapy, nuclear medicine. Didn't know a lot

4:54

about either one of them. I got all

4:56

my clinicals done the first year. They

4:59

give you two years, but I knocked them all out in one

5:01

year. I put my head down and I just went for

5:03

it. Like you said, it allowed you

5:05

your second year of the extra time that you had

5:07

to really focus in on those modalities.

5:10

And for me, CT was, they had a shortage

5:12

all over and that and radiation therapy

5:15

were my two things and later on I went

5:17

into MRI but I just

5:19

I just love the cross sectional part of it

5:21

of MRI you get to see and

5:23

CT as well but MRI there's a difference,

5:26

is way more detailed you

5:28

get to see things because the difference for

5:30

me with CT is when someone has Abdominal

5:33

pain. You usually go in for ultrasound or a CT. They don't

5:35

really don't know what's going on. You just got abdominal pain.

5:37

With MRI, and you could correct me.

5:39

Maybe you've seen some other things, but with MRI

5:42

you actually know what you're going for with MRI,

5:44

it's not a guessing game. You already know

5:46

there's something going on in the liver, so we're looking at

5:48

the liver. We're just not shooting in the dark

5:50

with MRI. What, what's your opinion on that?

5:52

I agree. I think partially because

5:54

they take so long. Imagine how

5:56

long it would take to scan. If we didn't

5:59

know, and we were just fishing abdomen

6:01

pelvis, for an MR exam, especially

6:03

with contrast, that would just take so long. That

6:05

would be miserable for the patient. We do kind

6:07

of see when you get into MR, when you come to

6:09

have an MRI, that it is typically a

6:11

little more focused or honed

6:13

in on what exactly we're looking for, looking

6:16

at.

6:16

Yeah, I agree. Back to the safety

6:18

part, because that is what you do. I see you wearing

6:20

your shirt for the company that you work for. We're going

6:22

to talk about that too, because I find

6:24

it interesting. Many companies that we don't

6:26

think deal with MRI safety deal with

6:29

MRI safety. But when it comes to MRI

6:31

safety if people are in school,

6:33

have you seen some really fascinating

6:35

or helpful tips that ones

6:37

can use as they're teaching students?

6:39

Because as I told you, when I was teaching for seven years,

6:42

students really wanted to kind of gloss over

6:44

the safety part. And I'm like, no, no, no, no, no.

6:47

If you can't be safe at MRI, you should not

6:49

be working at MRI.

6:50

Yeah. I think when you're a student

6:52

in MRI, there's so much to take in,

6:54

learning MR in general, there's a lot

6:56

to take in. And I feel like even

6:59

now, even being a seasoned, I would

7:01

consider myself a seasoned tech for 13

7:03

years. There wasn't a day when I

7:05

was in clinic where I could go in and not learn

7:07

something. There was always something to learn. I

7:10

think the biggest piece of advice that I can give

7:12

is don't gloss over that information.

7:14

No. If you feel a little overwhelmed,

7:16

that's okay. And that's totally normal, but

7:18

don't just skip it because it feels overwhelming

7:20

because it is really important, not just

7:22

to get good images for the physicians,

7:24

but also to make sure that your patients are safe and

7:26

they're not injured while they have this exam, do

7:29

no harm. That means don't make things any

7:31

worse than they already showed up as.

7:33

Yeah. The fascinating thing for

7:35

me with safety is sometimes even patients,

7:38

only think that it's projectile.

7:40

They don't talk about or really focus

7:42

on the burning, the burns that

7:45

people can sustain and do sustain

7:47

in MRI. We'll talk a bit about

7:50

that as well, because that's part of what you

7:52

do. You're just not an MRI safety officer to

7:54

stop people from coming in with projectiles

7:56

and, guns and bobby

7:58

pins flying. I saw this one on Chicago,

8:01

MED. It's like my TV show. I don't know. I've

8:03

done some little things about the funny parts

8:05

of medical imaging they show on TV,

8:08

but there's one with this MRI scanner and

8:10

a guy comes in. He's

8:12

having a mental episode and It

8:14

was so wrong. They pressed the button to turn

8:16

the MRI scanner off. And I just was

8:18

like, oh my goodness, this is bad.

8:20

This is really bad. But what they were

8:23

really focusing on was the projectile. And

8:25

like you say, the things that people see,

8:27

technologists and patients is important.

8:29

We're going to talk to you about the burns,

8:31

the, the burns that patients can sustain

8:34

as well as projectiles. When

8:36

it comes to your expertise, you had a bunch

8:39

of acronyms. What does MRSO, MRSE,

8:43

and all the boards that you're on, what do those

8:45

stand for and why should we know?

8:47

The American Board of MR Safety.

8:49

Would tell you who founded it. I think it was Manny

8:52

Kanal I could be wrong on that. But where

8:54

I think we're all familiar with Dr Kanal if we work

8:56

in the MR space. And the goal

8:58

was to provide some sort of formal training

9:01

to people regarding MR safety. And so there

9:03

were 3 certifications that

9:05

you could get in safety. And

9:07

those 3 are MRSO, MRSE

9:09

and MRMD. Now, MRMD

9:12

is gonna be reserved for a physician. It can

9:14

be any physician. It is typically

9:16

a radiologist. MRSO

9:18

is an MR. Safety officer, and

9:21

that's typically for a technologist, but

9:23

there's nothing that precludes anybody. You can

9:25

walk in from the street and go sit down for that

9:27

board if you want. And then MRSE

9:29

is an MR safety expert, and that's

9:32

typically reserved for physicists. Again,

9:34

there are no restrictions. Like anybody

9:37

can study for those boards and go sit

9:39

and take that test.

9:40

But let me tell you, those tests are not just walk

9:42

off the street and sit down take them. She's making

9:45

it sound like they're super easy. There

9:47

are education courses for it. Am I not correct?

9:49

There are. I don't know that they're necessarily

9:52

guided for "passing

9:54

the test", but Manny Kanal has a conference

9:56

that he does on MR. Safety. Toby

9:59

Gilk does some conferences for MR. Safety

10:01

as well. Just things to improve

10:03

your knowledge for MR safety.

10:05

Even if you're not maybe taking the exam

10:08

as technologist working in MRI, I

10:11

just find Dr. Kanal's information

10:13

so helpful throughout my journey at MRI,

10:16

really understanding the safety part of it. I mean,

10:18

it's super helpful even

10:20

for a technologist, but these roles.

10:22

And I think I worked at a children's

10:24

hospital and they were just starting

10:27

to bring in the MRSO and the MRSE.

10:30

And I was so fascinated by it because the physicist

10:32

is the one at the children's hospital who

10:34

was the first to get this certification.

10:37

And when he came back and he created a course

10:39

for all of us to take, my mind

10:41

was blown. This guy's like super smart, super

10:43

smart. And very humble as well,

10:45

but he created this course and the way he taught

10:47

that course I felt like I

10:50

really understood safety to a new

10:52

level, and I find working

10:54

with newer people in MRI I

10:56

just think this would be something really good,

10:58

even if you're not looking at a role in

11:01

the MRI department of being a

11:03

safety officer, or having

11:05

responsibilities, is something that I think

11:07

everybody could benefit from. Do you agree?

11:09

I mean at least having a basic understanding.

11:13

I'm not expecting you to be able to say, oh,

11:15

this is how the magnet works. And this is what causes

11:17

this, or this is what causes that. But at least

11:19

to say, how can I

11:22

protect my patient while they're in the exam?

11:24

You know, how do I protect myself and my team

11:26

members while we're in the MR environment? It's

11:28

crucial that you know that if you're going to be an

11:31

MR tech, and maybe that's not something that you get

11:33

right off the bat, but that's something that you should strive

11:35

to attain, right?

11:37

You should strive to know this is how I can protect

11:39

myself, my patient, and my team members while

11:41

we're in the MR environment.

11:43

You speak about a good point, protecting your team

11:45

members, because sometimes we think just protecting

11:47

patients, but sometimes, especially

11:49

in larger hospitals, you're working with another technologist.

11:52

I remember we worked at a hospital where

11:55

we trained students and there was a new technologist

11:57

and they didn't have the safety thing

11:59

set up like they do now where certain

12:01

wheelchairs just did not make it even down

12:03

to MRI. And some of those wheelchairs look

12:06

identical. I mean, they look totally

12:08

identical safe ones and unsafe

12:10

ones. You do not know if, if

12:12

one is safe just by looking at it. And

12:15

that's what happened. And people get to moving

12:17

really, really fast. And I

12:19

just happened to turn around, you know how you feel somebody

12:21

behind you. And I turned

12:23

around and she was coming in with this chair

12:26

from the waiting room. I don't

12:28

remember even walking. I think I floated across

12:30

the air. I was in a path

12:33

of where that wheelchair would have gotten sucked

12:35

to. And that for me would have

12:37

been terrible. And she felt

12:39

so bad, but I was like, this is a learning

12:42

experience. This is what we're going to take this

12:44

as, but it never made it into the room,

12:46

but I was aware enough of

12:48

who I was working with that she was new.

12:51

I was still trying to train her, but you also have to

12:53

be aware. You've worked in a level one trauma

12:55

unit before. What were your biggest

12:58

challenges that you faced ensuring MRI

13:00

safety?

13:00

I think probably some of the biggest things that

13:03

we dealt with were people

13:05

wanting just to come into zone 3 without

13:07

being screened. We followed, if

13:10

not all of them, the majority of ACR best

13:12

practices, the ACR manual

13:15

and MR safety we followed, if

13:17

not all of them, a very large percentage

13:19

of them. And one of our prerequisites

13:21

to coming into zone 3 was that you had to be

13:23

screened. And we did a lot of complex

13:26

exams, Anastasia, Nicu.

13:28

If you could do it, we did it essentially. And

13:31

we had a lot of people that wanted to bypass

13:33

that system or maybe I

13:35

don't want to say offended, but just couldn't understand

13:37

why they needed to do that. That

13:40

was one of the biggest challenges that we faced.

13:42

I think another big challenge that we faced

13:44

were seeing a lot of complex

13:46

patients, meaning they would have

13:49

one implant or multiple implants that would

13:51

need reviewed prior to their exam.

13:53

And then we'd have to make sure we accommodate

13:55

all of the conditions of all of these implants

13:57

and make sure that they get a safe exam.

14:00

That was another challenge is where do we get the resources

14:02

to do this stuff to make sure that our

14:05

scanner utilization stays

14:07

high and that our patient satisfaction stays

14:09

high and that we don't compromise their care in the

14:11

process.

14:12

Yeah, that's really important. Can you explain

14:14

to everyone what a level trauma one center

14:16

is? Like what makes it different? What kind of

14:18

patients do you see? Because that's not just your regular

14:20

hospital.

14:21

Where the worst of the worst go. I mean, we had

14:23

helicopters, lifestar. They

14:26

fly people in who are in very critical condition

14:28

to level one trauma unit. If

14:30

there's a complex exam that needs to be done,

14:32

it's probably coming to you if you're at a level one

14:34

trauma unit.

14:36

Practicality comes in for me here. When

14:38

you talk about zone three, maybe our

14:40

listeners, they don't know that we have different zones

14:42

in MRI. Can you break those zones

14:44

briefly down for us?

14:45

There are four. Conceptually, MR

14:47

should be divided into four zones. Zone

14:49

1 is going to be freely accessible to the entire

14:51

public. Think about something like a waiting

14:54

area. Zone 2 is

14:56

usually that interface between 1

14:58

and 3. That's typically where your patients are going to get changed.

15:01

They're going to lock up their clothes, any belongings

15:03

that they have with them. And then zone

15:05

three is your control panel

15:08

where your technologists are going to sit. It's

15:10

right outside of zone four, which is where the

15:12

magnet is going to be. Zone three and

15:14

zone four can be called the MR environment.

15:16

When she talks about that zone three

15:19

the challenges of keeping things

15:21

safe in zone three, sometimes

15:24

you work in facilities at your level one

15:26

trauma center where you by yourself at

15:28

a scan or did you usually have someone to help

15:30

you?

15:30

We had, we had five scanners.

15:33

And on any given day, we would have

15:36

six, seven, eight, technologists

15:38

there. It wasn't like there were 2 assigned

15:40

to 1 scanner, but we had additional people.

15:43

We had an additional half person or 1

15:45

person per scanner.

15:46

I was thinking how would someone, who

15:49

maybe doesn't work at a level one, but there are

15:51

level one trauma centers and they operate just

15:53

like this five and seven scanners. I worked there when they had

15:55

seven scanners and they were always busy. I'll

15:57

talk about what we did, but this was years ago

16:00

and now things are even

16:02

more focused when it comes to

16:04

the MRI safety at places like this. What practical

16:06

tips can someone maybe working in the outpatient

16:09

center at a mid level hospital

16:11

or a level one start to

16:13

have as part of their resources,

16:16

because as we know we don't always have that

16:18

many techs available. Sometimes we're

16:20

alone. Someone comes in with an

16:22

emergency. They're not always

16:24

able to tell us clearly

16:26

what they have or show a card. What

16:28

are some practical things that someone

16:31

with maybe two techs in an environment

16:33

like that can do to make sure they are

16:35

following MR safety protocols?

16:37

I think the very first thing would be

16:39

for the facility to designate

16:41

an MRMD and MRMD is going

16:43

to be ultimately responsible for all

16:45

MR safety, right? They're going to be responsible for

16:47

the patients while they're having the exam then

16:50

after that you can appoint someone

16:52

to be an MRSO and an MRSE I

16:54

mean, I think having a formal training and having a certification

16:57

is great. I don't think it's required

17:00

to do that. I think you should strive for that if

17:02

you are going to say that you're an MRSO

17:04

or an MRMD. After appointing an MRMD,

17:07

MRSO, MRSE, I would have policies

17:09

and procedures have well defined practices

17:11

that you believe are best for the patient.

17:14

That helps protect your technologist too, because they

17:16

were acting in the interest of the MRMD. Secondary

17:18

to those things, I think having badge

17:21

access control to zone 3 or key

17:23

code access. I don't personally

17:25

love a key code access because we know that gets

17:27

shared. If that's your only option,

17:30

do that. And then outside

17:32

of that, make sure if you're not using

17:34

zone 4, that the door to zone 4 is closed.

17:36

If you're going to step away for any prolonged amount

17:38

of time, lock the door have

17:40

policies in place that help protect you if

17:43

there is an emergency, meaning if you have a code,

17:45

you know how to respond to that code, you know who does

17:47

what, who can get into zone 3.

17:50

Policies and procedures they should never be overlooked

17:52

because those kind of define how we're going to practice

17:54

normally, but then also how are we going to practice

17:57

if there is an emergency? What are we going to do if there's a

17:59

code? Where are we taking the patient to? Who's

18:01

showing up for that? What physicians come in

18:03

or what physician do I need to call?

18:05

Those all important because I love how you

18:08

are showing us strong MR

18:10

safety protocols. You can have

18:12

protocols, but these are well defined,

18:15

strong MRI protocols for

18:17

safety of everyone, not just the patient.

18:19

Now let's kind of move over to the MR

18:22

safety and technology. When you talk

18:24

about ferromagnetic detection systems,

18:26

that seems crucial. Can you explain how they work

18:29

and the importance of MRI safety? Because people think

18:31

all metal's bad.

18:32

Ferromagnetic detection, there are, at least

18:34

with my company, we have two different kinds.

18:37

We have something that we call a patient screener,

18:39

and then we have a system that we call an entry control

18:42

system. The patient screener

18:44

is going to be the most sensitive detector

18:46

that we have, and that is going to be to try

18:48

to find anything that's on or in your

18:50

patient's body prior to entering zone 3.

18:52

The importances of that would be one,

18:55

if it is ferrous or if they do have a ferrous implant

18:58

or something ferrous on them. That

19:00

can become a projectile, or if

19:02

it's implanted in their body, it could, it could migrate

19:04

being exposed to the magnetic field, the

19:07

entry control system. The purpose of that is

19:09

to prevent medium to large

19:11

size items from becoming projectile in

19:13

the MR environment. That is going to

19:15

be a little less sensitive than the screener.

19:18

Won't pick up small things like bobby pins,

19:20

probably won't detect things that are implanted in

19:22

your body, but the purpose of

19:24

that is if somebody is walking toward the system with

19:27

a ferrous oxygen cylinder, it will notify them

19:29

before they get into zone 4 and we

19:31

have an adverse event.

19:32

You have different types of ways to detect

19:35

it. I love that your company is really

19:37

setting the standards on that. Now, you spoke about ACR,

19:39

setting the best practice standards for MR

19:42

safety. We've all been to places.

19:44

They're like, yeah, we have our ACR sticker.

19:46

I think Tobias Gilk just had a video

19:48

or something where they had the sticker on it and the wheelchair

19:50

was inside the scanner. Can you elaborate

19:53

on how your training aligns with those recommendations?

19:55

Because we go to some places, I know me as a

19:57

consultant, going to some places, helping them

20:00

try to get things together. They have

20:02

no clue. Like nobody knows what ACR is, but they

20:04

have the sticker right there. And it's kind

20:06

of lax, especially when it's not larger places.

20:09

Anything that I recommend in regards

20:11

to ferromagnetic detection is going to align

20:13

with ACR, the manual

20:15

on MR safety best practice recommendations,

20:18

meaning when we talk about walking patients

20:20

into the room, if the door is open,

20:23

remember, the entry control system is not for screening

20:25

patients. That system is going to be to prevent

20:27

medium to large size hazardous items

20:29

from coming in the room. But say

20:31

I open the door and I'm about to walk a patient

20:33

into zone four. Because there's no barrier

20:36

now between the patient and the magnet, right? We've opened

20:38

the door. The door was the barrier. I'm

20:40

going to make myself the barrier. Have the patient

20:42

wait, and then I'm going to go through first and then I'm

20:44

going to say, okay, now you can come in. The

20:46

great thing about the entry control system is that

20:48

if the patient picks something up. We

20:50

changed everyone down to skin, but we did have

20:52

paper pants that had pockets in

20:54

the back. Let's say they left their cell phone or a key or

20:56

something in the pocket, the entry control

20:59

system will detect that and it can also

21:01

detect things like an insulin pump.

21:03

Insulin pumps have various signatures that are large

21:05

enough that it can be detected by that. Two

21:07

reasons I'll go in first and now

21:09

I'm the barrier, right? We're in alignment with ACR

21:11

recommendations. But additionally, I won't ever

21:14

go through simultaneously with the patient

21:16

because if I'm not ferrous free at my

21:18

job, which could be a watch or

21:20

Dansko shoes or an underwire bra, if

21:22

I walk through at the same time that the patient does,

21:25

well, now we have no way of knowing who set

21:27

it off. Is it me? Or is it the patient?

21:29

Yeah, you spoke about some shoes. I've got

21:31

a story about that too, but I'll save that for another time.

21:34

People don't think shoes. It's a lot of

21:36

little things that we

21:38

just do not think. Now, athletic wear, and I

21:41

hear some underwear.

21:42

I think dressing your patients down

21:44

to skin. I think that's

21:46

probably the best practice that I can recommend.

21:49

I have no idea what your clothes

21:51

are made out of and a lot of people will

21:53

say, oh, I looked at the tag and the tag said

21:55

100 percent cotton, but

21:57

clothing companies, there can be like a 5

22:00

percent impurity and the tag doesn't have

22:02

to disclose that. There could be microfiber

22:04

or the metallic fibers woven

22:06

into there, and if it's only 5%, that still

22:09

puts your patient at risk.

22:11

Yeah, I was going to talk about that as my other

22:13

question. This leads right up to it. We're

22:15

talking about changing people down. I have

22:17

a YouTube page and people are on there saying, there's

22:20

no kind of system to this. Because when

22:22

I went to one place for an MRI, they let me just

22:24

take my belt off and told me to check my

22:26

pockets. And then another place made me take off everything.

22:29

We've got to really get into like, like you said,

22:31

strong MR safety systems

22:33

and protocols following ACR guidelines

22:36

and even changing down to the

22:38

skin. I love that term.

22:40

Yeah, maybe there's been an evolution

22:42

of this, there was a point in time where we didn't change people

22:44

for an MR exam. And then it was like,

22:46

okay, well if it's gonna be exposed to the transmit

22:48

field, let's change them. But one of the things that I

22:51

advocate for is it's just to have that kind of as

22:53

a blanket policy that we're going to change everybody

22:55

down to skin. Especially if you've got

22:57

patients that share a dressing room waiting

22:59

for their exam. They're all going to be talking about why

23:01

did you get to keep this on and I had to take everything

23:03

off? And they don't understand or just like

23:05

you said hey I went to this other facility and they didn't

23:08

make me change anything or the last

23:10

time I had an MRI I got to wear this and this

23:12

so just for consistency sake because our

23:14

patients don't know it's probably

23:16

best to change everyone down to skin

23:19

And when you say that, talk about microfibers and

23:21

clothing, what we don't talk a lot about or see

23:23

on these TV shows is burns,

23:25

MRI burns. How common are MRI

23:28

burns?

23:29

They're the number one reported adverse event.

23:31

I think we see a lot of these photos of projectiles

23:34

and things stuck to the magnet. They photograph

23:36

well. They get a knee jerk reaction, but

23:39

it's not fortunately, not as common

23:41

as burns. Not that it's fortunate that there's

23:43

any sort of adverse event, but those

23:45

are typically or can be more detrimental

23:47

than a patient receiving a burn.

23:48

What are some of the top three reasons that

23:51

burns happen?

23:51

Proximity burns, I think, is number one.

23:54

Proximity burn is going to be when the patient touches

23:56

the bore of the magnet, the transmit

23:59

field. The 2nd one probably

24:01

that we're looking at would be a reflective burn.

24:03

That's going to be people wearing like their Lululemon clothes

24:06

in there, or their spandex

24:08

or sweat wicking, those things can also burn.

24:11

And then the other two burns are like looping

24:13

burns or resonant burns. A looping burn

24:15

could be, maybe you're laying in the scanner

24:18

and you're laying with your arm over your head

24:20

and your thumbs touching your ear. Any small

24:22

amount of skin to skin contact can cause that

24:24

looping burn.

24:26

Yeah, EKG leads. I know when I used

24:28

to work in inpatient, I would

24:30

always just check the snap, make sure this

24:32

gown was not a snapping gown. A lot of times

24:34

on the floor, those are easier to get to with

24:36

the patient. I understand, but in MRI, they are not

24:38

safe. I would have to roll patients

24:40

over to make sure. Because if they're in the hospital any period

24:42

of time, those EKG leads get detached

24:45

and it will wind up in the back. They wind

24:47

up all down on the leg. They just migrate

24:49

everywhere. But it's my job to

24:51

make sure the patient is safe. I even

24:53

had a patient recently, wasn't my

24:55

patient. And state that they had an

24:57

MRI before at a facility

25:00

and they didn't have to take out their nipple

25:02

rings. Some places get more jewelry

25:04

than others. That's one thing that I find

25:07

technologists are telling me they're running into and

25:09

patients say, well, they just told me to put a piece

25:11

of tape over it. And again, it goes back to

25:13

not having a knowledge. We're

25:15

not talking about projectiles here. We're

25:17

talking about burns.

25:19

Yeah, I think some jewelry can become

25:21

a projectile. I mean, if it's ferrous, some

25:24

of the costume jewelry is

25:26

made out of ferrous components and that stuff can

25:28

become a projectile, but you're also potentially

25:30

exposing your patient to an RF

25:32

burn when you let them wear their jewelry in there.

25:35

Yeah. I'm like you, I just rather be

25:37

overly cautious, even if it doesn't

25:39

go off and it's gold. I just need you to take

25:41

it off anyway. Going 20 plus years without hurting

25:44

anybody. I need another 20. And when I

25:46

do that, most of my patients go, Oh, you're so

25:48

right. I don't want to be your first. Let

25:50

me take it off. You got to make a joke

25:52

out of things sometimes and make people

25:54

laugh to get beyond

25:56

that awkwardness or them already coming in

25:58

claustrophobic, mad that you're making them take

26:00

everything off. Make a joke out of

26:03

it. Say, look, I hadn't hurt anybody in X, Y,

26:05

Z years. That's all part of our training.

26:07

We want to keep everybody safe, but your role

26:09

at Metricens, please tell us about

26:11

it. Techs sometimes feel like their role

26:14

is only patient care in

26:16

radiology, I just was so drawn

26:18

to your profile on LinkedIn because

26:20

to me, you are like a poster

26:23

child that shows we have so

26:25

many options in radiology and medical

26:27

imaging that it's not all patient

26:29

care. Only thing we think about is sometimes sales,

26:31

clinical applications, but

26:33

what you're doing, Kellye, is for

26:36

me, really good to see. Tell us

26:38

what it is you do, what your company is about

26:40

and help technologists to see

26:42

what amazing things radiologic technologists

26:45

can do.

26:45

Work for Metricens and what we do is we

26:47

create a ferromagnetic detection systems

26:50

to integrate into zone 2 and 3.

26:52

Like I said earlier, the patient screener that goes in

26:54

zone 2, and that's to help identify

26:57

any small ferrous objects that are on

26:59

or in your patient. And then the inter control system

27:01

that is in zone 3, just

27:03

before you enter zone 4. My role

27:05

at Metricens is the MR safety trainer.

27:08

And so part of my job is to be the subject

27:10

matter expert, and then I

27:12

get to go in online or in

27:14

person and train technologists

27:16

how to integrate ferromagnetic detection

27:18

into their workflow. And not

27:21

just to integrate it, but to integrate it effectively.

27:23

We know that you've probably seen online,

27:26

some people say, Oh, these things go off

27:28

all the time. And so part of what I'm trying

27:31

to tackle is to teach people what

27:33

will produce an alarm? And how do we make sure

27:35

that these alarms are significant when we do

27:37

get an alarm?

27:38

I want to tell you a quick story. I worked at a hospital and

27:40

they installed them. Nobody gave us training.

27:43

We kind of walk through it. It would just go off all the

27:45

time. We eventually people started ignoring

27:47

it and going back to the hand wander, because

27:49

we literally just got an install showed up one

27:51

day. I thought it was great. Once I figured out how

27:54

to use it, but I never got training. Even

27:56

if I was using another scanner, I would take

27:59

my patients through that particular

28:01

one. It was so good. Once

28:04

I understood how it worked, and it was

28:06

the only hospital I've ever worked at,

28:08

but it was a very large hospital with seven

28:10

busy scanners, and they invested in

28:12

it. They invested in a lot of good things,

28:14

that hospital did, which saved, a lot of patients

28:16

and technologists. Kudos to them. But

28:19

that was my first time seeing it. I don't know what company

28:21

it was, but I was so impressed

28:23

by it. And to now have you on our podcast,

28:25

educating us about why

28:28

facilities should use it. They even had one on the

28:30

wall. Now that we know what your company

28:32

does, how would you, encourage

28:34

maybe someone in our field or

28:37

give them advice in their career for MRI

28:40

technology and especially MRI safety.

28:42

What encouragement would you give them?

28:44

I think the first bit of encouragement

28:46

that I would recommend would be to get some formal

28:48

training. Study for an MRSO

28:50

certification, sit for a board, pass

28:53

it. I don't know that I'm going

28:55

to recommend that everyone take the MRSE.

28:57

It's more driven for physicists, but I will

29:00

say that it never hurts to take it. It never

29:02

hurts to have more knowledge. Put

29:04

yourself in an environment where you can apply

29:06

that knowledge. If you're working in an outpatient facility

29:08

that doesn't scan any active implanted medical devices,

29:11

try to get on at the level one trauma unit.

29:13

Try to get on in a facility where you're going

29:15

to be more exposed and you're going to be able to test that

29:17

knowledge and apply it every day because

29:19

the saying is true. If you don't use it, you will

29:22

lose it. For me, at least don't just go

29:24

sit for a board and sit and say,

29:26

okay, now I have these extra initials after my name,

29:28

actually do something to apply that knowledge

29:30

and make sure that you're staying up to date on that knowledge.

29:33

And that can also look like every

29:35

year. I mean, we, as a

29:37

radiological technologist, we have to get continuing

29:39

education, so maintain those,

29:42

make sure that you're attending conferences related

29:44

to MR safety, that you're taking online courses

29:46

related to MR safety, that you're focusing

29:48

in your CEUs even on MR

29:51

safety, just make sure that you're continually digesting

29:53

stuff and learning, because I don't think there's a

29:56

lack of things that you can learn, especially

29:59

when it comes to MR and MR safety.

30:01

I totally agree. Looking ahead, what

30:03

exciting advancements or changes do you

30:05

see in the horizon for MRI technology and

30:08

safety protocols?

30:09

I think probably the biggest one right now that

30:11

everyone's talking about is remote scanning.

30:14

I think there are a few different methods for

30:16

remote scanning, but I'm excited to see what

30:18

comes out of this. And I'm excited to see

30:20

the MR safety recommendations and best

30:22

practices that are developed as a result of this,

30:25

because I think this could be really advantageous

30:27

to a lot of facilities and to a lot of patients ultimately.

30:30

Thank you so much. And Kellye,

30:32

it has been great having you on

30:34

as a guest on A Couple of Rad Tech's Podcasts.

30:37

We appreciate all of Your expertise when

30:39

it comes to MRI safety. You're always

30:41

welcome back.

30:42

Oh, thank you for having me. It was so fun to get

30:44

to talk about MR safety.

30:46

If you want to check more out about Kellye and learn

30:48

more about MRI safety. Kellye

30:50

Mantooth. You can find her on LinkedIn

30:52

and I will put all of her links right

30:54

there in the description. And thank you for

30:56

listening to A Couple of Rad Techs Podcast.

30:59

And that's a wrap for this episode of a couple of

31:01

rad techs podcast. We hope you enjoyed

31:04

our discussion of the fascinating world of radiology

31:06

and learn something new about the role we play

31:08

in the healthcare industry. If you have any

31:10

questions or topics that you love for us to cover,

31:13

feel free to reach out and let us know what they are.

31:15

And you guys, please, if you enjoyed

31:17

this podcast or any of the other episodes,

31:19

we want to hear what you think. Thought leave us a

31:21

review. Mama's got to pay our bills. It

31:23

helps. And until next time, stay

31:25

tuned for more insightful and informative episodes

31:28

of a couple of rad techs podcast.