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Good afternoon -- We are reworking our MRI CIED policy at my institution. We have ironed out the conditional CIED section; however, there's much debate about whose presence to require in either Zone III or on the premises for non-conditional</div>
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<div dir="ltr"><div>Good afternoon --</div><div><br></div><div>We are reworking our MRI CIED policy at my institution. We have ironed out the conditional CIED section; however, there's much debate about whose presence to require in either Zone III or on the premises for non-conditional CIED scanning.
To my knowledge, we have never had an approved MR scan of a patient with a non-conditional CIED. Therefore, I was curious, for those institutions out there that have had to reference their policy for this scenario, who do you require in the immediate vicinity and who is OK just on the premises? And do you break your policy down for the non-conditional section into pacing-dependent and not pacing-dependent?</div><div><br></div><div>In following the HRS guidelines (and common sense for some of it), we are of course requiring EEG/pulse ox monitoring by a nurse in Zone III, as with conditional CIED patients. ACLS trained personnel must be in the immediate vicinity/on premises for conditional CIED patients, but should it be a requirement that they are in Zone III for non-conditional? Just for pacing-dependent patients? Is the ability to call a code sufficient? It was brought to our attention that the nurse that accompanies a patient may not always be ACLS trained, just BLS. And for non-conditional, should all effort be made for the device rep to be there at the time of scanning (interrogations and programming)? What part does cardiology/device clinic have in all this in an emergency?</div><div><br></div><div>I feel like we have been debating this policy for close to a year now, so I wanted to put my feelers out for anyone who is actively doing non-conditional pacemakers. What works on paper may not work in real life.</div><div><br></div><div>Many thank yous in advance,</div><div><div dir="ltr" class="gmail_signature" data-smartmail="gmail_signature"><div dir="ltr"><div><div dir="ltr"><div><div dir="ltr"><div><div dir="ltr"><div dir="ltr"><div dir="ltr"><p style="text-align:left"><font face="tahoma, sans-serif"><span style="font-size:small">Gretchen R. Bell, M.S., DABR</span><br><font size="2">Diagnostic Imaging Physicist</font><br><font size="2">Ochsner Medical Center</font><br><font size="2">(504)842-8506</font></font></p>
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