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Welcome to A Couple of Rad Techs podcast, where we bring you an inside look at the world of radiology from the unique perspective of a married couple of radiologic technologists.

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Together, we have over 30 years of experience in the field and are here to demystify the science of medical imaging.

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Radiology is the unsung hero of the medical field, providing doctors with crucial images and information that help diagnose and treat illnesses.

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Join us as we explore the latest techniques, technologies, and innovations in radiology and discover the vital role we play in the healthcare industry.

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So come along for the ride as we share our passion for radiology as a married couple.

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Welcome everyone, I am Chaundria, and I'm the host of A Couple Of Rad Techs Podcast.

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Today's episode is one that has been highly requested about MRI scans and MRI safety.

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Let's get right into it. Before we start, make sure you pull out your pen and paper because if you've ever had an MRI scan and felt unprepared, this is the episode that is going to change that the next time you have to have an MRI scan.

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I have been doing MRI scans for more than 15 years and I'm a little claustrophobic myself.

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I'll tell you some of the things that I do that help ease the anxiety of these MRI scans and what you can do the next time.

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Today we're going to be really going deep and giving practical information about MRI safety.

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It's not talked about as much as it should be.

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When it is talked about, people only focus on projectiles.

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But we're not only concerned with things flying at the patient or into the scanner.

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I'm going to talk about what else you should be aware of before your next MRI scan.

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What are MRIs useful for? MRIs are a fantastic diagnostic tool used by radiologists and referring physicians to help patients and doctors determine what is going wrong with them or maybe to get further information and look deeper into what they already know is going on.

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We can image any part of the body, not just the brain, not just the bones.

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We're looking at soft tissue, pathology.

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We're looking at all types of anatomy.

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If it's on your body, we can see it with MRI and it's very safe when we employ safety protocols that are out there for us all to apply.

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One thing I really get concerned about when I do patients is when they tell me what the last MRI scan I had, I didn't have to do this.

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Why are you making me do this? Why are you making me take this off?

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Then I have to go in and explain the reasons why.

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Unfortunately, safety protocols were not followed the last time, but I assure my patient the last 21 years of doing medical imaging, CT, MRI, radiologic technology, I have never injured or hurt anyone.

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I don't plan on starting with them. That usually helps put them at ease.

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They're like do whatever you got to do. I don't want to be your first person.

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That is one of the things that goes into safety is being consistent every time we do a scan.

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Consistency will make sure we have incidents that are very rare.

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Things happen. We all know that. But over the next 10 minutes, we're going to talk about reasons why strict safety protocols are in place during and before MRI scan.

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Most people already understand magnets, but we usually have a little teeny magnets, right?

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We've all played with magnets growing up, but imagine a MRI scanner Is a humongous magnet.

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Even with the smaller magnets, you can't control what is attracted to it.

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The MRI scanner, which has a force that no human on earth can control because it's always on and it will attract ferrous material.

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Things such as iron, steel, nickel.

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Many times some metals you may think are pure gold or pure silver, they're not.

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Hence why we ask you to remove all jewelry, for your safety.

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That's the strength of a magnet and each magnet is going to be different.

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Just because it's an open magnet does not mean that it's not a strong magnet.

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There are open scanners or vertical scanners as some people call them.

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They actually can go up to one Tesla.

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Some of them are 1. 5. They're just as strong as one of the closed units as people call them or the tube like structures.

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But there are scanners that are as high as 7+ Tesla.

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That is so powerful.

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Most scanners diagnostically are 1.

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5 to 3 Tesla. Which is very, very strong.

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We don't play around with things like that. We don't want to injure the patient, injure the healthcare workers.

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We don't want to cause injury or harm.

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What are MRI safety concerns? Here are the key reasons for MRI safety being so important.

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Number one, projectile hazards. This strong magnetic field can turn everyday household items such as a bobby pin into projectile dangerous objects.

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Imagine a stray pin or a wheelchair flying across at such a high speed, towards the magnet and you're laying in the magnet or sitting up in the magnet.

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What do you think the danger for that could be?

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Let me know in the comments. What else do you think could be attracted?

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What are some of the everyday things that you may have in your pocket that if you don't change for your next MRI scan could actually become projectile objects?

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I'm just gonna say a hairpin because I wear hairpins all the time.

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I've seen them fly out of people's hair and some people come in with bobby pins all in their hairdos and they've just got them freshly done and they're like, I just paid a hundred plus dollars for this hairstyle.

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I cannot take it out. I'm going to reschedule that MRI.

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Especially when we're doing scans of the head area.

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And bobby pins do get pulled out even if they're deep within the head.

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We have to be careful not only for the patient's safety, but the technologist as well.

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I have personally almost been hit with keys.

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Have you ever seen anybody with a wad of keys?

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Like you can't even hold the keys in your hand. I remember removing them from the patient and the patient's family member snuck them back to the patient.

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This is another reason in safety wise, only certain people are allowed back in those areas.

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Sometimes family members are allowed.

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But it's so important when they have items and they're given those items, not to sneak them back to the family member.

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Because I was almost gouged in the eyes with these keys that were massive flying towards me as I was moving the patient into the scanner.

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I happened to just see them moving underneath the sheet that was covering the patient.

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I'm like, what is going on? And my face was right there looking down to see.

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These are the dangerous things that not only happen to patients, but can happen to technologists as well.

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We need to stay safe. Number two, implant malfunction.

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You would not believe how many people have implants.

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When I first started, you saw stints, pacemakers, those types of things.

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Now we're seeing all type of implants, loop recorders, brain aneurysm, clips, coils, grafts, stints everywhere not just in the heart.

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There are stints that could be everywhere in the body.

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We have to know what type of stint because not all stints are MRI safe.

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We have to make sure those things that are implanted, such as pacemakers, defibrillators.

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Some pacemakers are safe, but not all pacemakers are safe.

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You can't put a patient in the scanner without properly turning off those MRI safe pacemakers.

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We get patients many times that come in and say, well, I got a pacemaker now, my doctors told me they're safe.

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What type do you have? We still have to have documentation on every implant to make sure that we document that these items have been checked, that if they are not MRI safe and conditional, what conditions should we meet to make sure that the patient scan is done safely and appropriately according to the manufacturer's direction.

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That's why documentation is important because we never want to do harm.

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We take an oath not to do harm on purpose to patients.

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In MRI, despite it not having ionizing radiation, it's super dangerous if you do not follow the safety protocols.

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That goes for technologists, radiologists, referring physicians and patients.

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It's our job as MRI techs to make sure that whatever happens in that MRI suite is safe.

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Patients need to understand why we say and ask for certain things.

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Implant malfunction. We don't even want it to malfunction because once exposed to the magnetic field, it could shut things off that need to continuously be running.

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Say if a patient had medication being injected into them through a pump that's implanted.

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Some people say, it'll just kill my battery. Don't worry about it.

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I've had patients tell me that before and no, I can't do that.

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We're not worried about it pulling out of the patient. What we're worried about is the patient actually getting too much medication injected into them because the pump is now malfunctioning because the magnetic field messing up the functionality of the implant.

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And now it's just delivering too much medication to the patient.

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There's actual case that was shown where a patient's pump was exposed to an MRI magnet.

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It was not emptied of the medication.

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The patient got an overdose and unfortunately is no longer with us.

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This is why MRI safety is so vitally important that we all follow it.

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We don't make excuses, try to make it convenient for the patient.

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We want to make it safe. Tissue heating is one of the highest incident reports in MRI.

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I did a poll on my social media and most people said it's projectiles.

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It's 55%+ tissue heating.

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How can the tissues heat? There are various ways.

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I'm going to show you a graph on the screen how we do not allow patients arms to touch the bore or circular part inside of the MRI tube.

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Why? Because that is part of the MRI scanner that gets warm.

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And if your skin is touching it, not immediately, it won't burn you, but over a period of time that you're in that scanner, it can cause burns to the skin.

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We do not want that to happen. We will put, as you see in this diagram, a buffer of at least one inch thick between the patient and the actual scanner.

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Sheets don't really do it. You have to have a certain amount of thickness next to the arm, like a barrier.

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The other thing I tell my patients is don't cross their legs.

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Don't cross their arms because you can create a current by crossing the arms and the legs.

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We don't want that to happen because now your skin can heat up and when it's touching each other, you can have a burn.

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We'll talk more about burns and tissue heating in another video because it is so extensive.

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We need to educate ourselves and understand that tissue heating is very important.

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There are certain implants like really old hip replacements.

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I remember years ago when I first started, the patient was like, I am so hot.

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They could feel the heat in there. And we already knew that this hip replacement was old and we had already watched it.

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We decided with the radiologist, which sequences would be the most vital to get instead of running a whole 30 minute hip sequence back at that time.

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The radiologist said, just get me three planes.

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It's a lot of metals. Give me some metal suppression and let's go for it.

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That's what we did. We just had to get the best quality imaging in a shorter period of time.

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So the heating would not happen. We weren't worried about it pulling out of the patient.

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That was not an issue. It was the heating issue.

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This is what causes burns. Certain tattoos as well.

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We have to be careful. Tattoos for the most part are not a problem.

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It's when they're newer. And you have to look at also the amount of tattoos someone has, the length.

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Some are like sleeves and have certain type of inks they're using now.

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Things are just so much more advanced nowadays.

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We're gonna also talk about clothing when it comes to heating and RF burns.

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It can also include our clothing. We wanna make sure that when we are asked to change, I get this a lot of times as well too.

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I ask patients to put on the gown. They'll put it on and underneath the gown, they still have the clothes on.

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You have to remove everything. You'll be surprised that underwear now, t shirts.

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They are designed with certain type of material to absorb sweat.

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We don't want you to not be able to release heat out of your body naturally when it comes to MRI because that is what helps you to cool off during the MRI.

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Let me know in the comments, have you ever had an MRI and you've come out sweating?

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You're burning up hot. Some people get really hot, more than others inside of an MRI because it does warm you up as well.

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We don't need you covered up with extra clothing that does not allow you to dissipate heat because now that can cause the burns.

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That's one of the reasons. Fourth, image quality.

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Metal objects near the scan area would distort the MRI images, making it difficult to interpret.

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Take a stimulator in someone's back.

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They have a stimulator in their back. If we're trying to look at your spine and your artifacts, your metal object in your body obscures what the radiologist is trying to see.

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It's going to be hard to give a really good interpretation.

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It can lead to a delay in diagnosis and lead to inaccurate results.

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Those are all important reasons why MRI safety is important.

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We want to ensure that you are safe during your scan.

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Four ways we do that is screenings, clothing, communication, and monitoring.

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I'm going to touch on those briefly. Before you get an MRI scan, we ask that you fill out an MRI screening form.

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It should not be done days, weeks, or months prior, or reprint off the old one and change the date.

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Proper protocol is you need to refill out a new one every time you come in.

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It needs to be done the day of the scan. Why?

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I'll give you a good example. A patient came and the screening form was already filled out.

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It was dated and I asked her, was everything on here correct?

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I always go over with them verbally. Is everything on here correct and accurate?

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She looked at it. She said, no, I just had a cervical spine surgery.

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I'm like, it's not on here. She was like, I didn't fill that out.

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I said, you didn't fill this out today? No. That was a while ago.

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I had that surgery about a month ago. It's not on this paper.

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I said, did you have anything else done? That's a good reason why the scan should be done because people can come in for an MRI scan if they had a pacemaker put in the day before.

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And you're back out walking, going grocery shopping with your family.

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Well, if we keep your old form, that doesn't tell us that you had a pacemaker put in yesterday.

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Screening is so important. Please don't get mad at us when we ask you to fill that form out every time.

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I'll get people to say, my surgeries are on a list.

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We don't keep a list at most places and that list is not always accurate for the reason I just gave.

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It's vitally important. Unless you're comatose and cannot speak for yourself, we find a family member that can, or the doctor is giving their consent that they are willing to take the responsibility that they've looked over your medical records and there's nothing that they see that will be contradictive to you having the MRI scan.

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Most times it is important that you fill it out yourself and you sign it the day of your appointment.

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If you're out there and you say you don't want to just know it's all for your safety and we really want you to because that's the safe way to get an MRI scan.

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Don't let anybody else fill your forms out. Clothing.

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You're gonna be asked to change. Remove any clothing that's from the outside and you should be willing to do it because many times we don't know what's in our clothing and we do not want you to have any burns and I'm sure you don't want any either.

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Communication. You'll be in communication throughout your exam with the technologist.

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Before, after, and during. Be sure to speak up and ask any questions.

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You will be monitored during the scan. Many times they will monitor your vital signs.

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We have MRI safe EKG leads, ECG leads.

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We have post oximeters that we can put on your finger to monitor your pulse rate, to make sure that you are still with us during the scan.

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We have cameras inside the scanner that we can watch you.

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We talk to you through the microphone. You can hear us through the headphones.

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Those are the many ways we monitor you.

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Now, how can the patient participate?

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Three ways. Number one, be honest. Please disclose every piece of information that you can remember about your medical history, implants, and medications before your scan.

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Tell your doctor, put them on the MRI screening form.

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It's going to ask you all of that stuff. Number two, ask questions.

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Do not hesitate to ask any questions about the safety of the procedure.

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You are never bothering anyone. Don't let anyone make you feel rushed.

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Ask the questions that you need to ask. Number three, follow instructions.

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When they ask you not to cross body parts, please don't do it.

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It can move coils and now you move yourself around and you're touching a coil.

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Make sure you don't move during the scan. That could prolong your scan.

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And if you have certain implants that only allow us to scan you for a period of time, then if we need to repeat, we can't.

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It's very important that you follow instructions.

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If they ask you to change, be sure to change.

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It's only for your benefit. I hope all of this was helpful.

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In order to understand the reasons behind MRI safety and participating actively, you can ensure a smooth and safe experience.

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Remember, a little preparation goes a long way.

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Thank you for joining us. Stay safe. Now you're ready to get it done safely.

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And that's a wrap for this episode of a couple of rad techs podcast.

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We hope you enjoyed our discussion of the fascinating world of radiology and learn something new about the role we play in the healthcare industry.

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If you have any questions or topics that you love for us to cover, feel free to reach out and let us know what they are.

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And you guys, please, if you enjoyed this podcast or any of the other episodes, we want to hear what you think.

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Thought leave us a review. Mama's got to pay our bills.

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It helps.