[Intl_DxMedPhys] Non-Conditional CIED in MRI

[Gretchen Raterman Bell]

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 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?

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?

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.

Many thank yous in advance,

Gretchen R. Bell, M.S., DABR
Diagnostic Imaging Physicist
Ochsner Medical Center
(504)842-8506
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