SOP104: Medical Emergencies

  1. Summary

    This document establishes procedures for medical emergencies at a BIAC MRI scanner.

  2. Scope

    These policies apply to all investigators, research assistants, and MRI operators who use the BIAC research scanners.

  3. Definitions

    • Subject - An individual who is participating in an experimental protocol at BIAC and has not taken the BIAC safety course.

    • Magnet Room - The room within the MRI suite that contains the MRI scanner. It is accessed from within the console room through a doorway that is controlled by an electronic lock.

    • Console Room - The main room of the MRI suite that contains the computer displays and keyboards that control the MRI scanner. The console room is accessed from the main hallway through a doorway that is controlled by an electronic lock.

    • Electronic Lock - All doors in the BIAC MRI suites are controlled by electronic locks. A single electronic key card is used for entry. The electronic lock system recognizes the owner's key card, logs the time of the attempted entry, and unlocks the door if the owner has been granted access.

  4. Policies and Procedures

    1. A Subject loses consciousness, complains of chest pains, stops breathing, or complains of difficulty in breathing during a MRI experiment.

      1. Call the code operator and say:

        "We have a patient with [chest pain, unresponsiveness, respiratory problems] in the MRI suite, Radiology, Duke North."

      2. Summon help from the nurses station in the main hallway.

      3. If the Subject is in the scanner, remove them from the bore and roll the gurney into the Console Room.

      4. If it is after hours, make sure somebody is at the front doors near reception to allow code team to enter.

      5. After medical staff have attended to the Subject, refer to procedures in SOP102: Adverse Events.

    2. The Subject is injured by a projectile, by a fall, or by some other accident.

      1. If the Subject is within the magnet and can be safely removed, remove them from the bore and roll the gurney into the Console Room.

      2. If the Subject is otherwise ambulatory, remove them to the Console Room.

      3. If the Subject is unconscious and/or appears severely injured, do not attempt to remove them from the Magnet Room without qualified medical assistance.

      4. Call the emergency room and request help.

      5. If requested by the emergency room physician, escort the Subject to the emergency room.

      6. After medical staff have attended to the Subject, refer to procedures in SOP102: Adverse Events.

    3. The Subject is trapped in the bore of the magnet by an object, or is pinned to the magnet by an object, but is conscious and uninjured, or reports having sustained only minor injuries.

      1. Summon help from the nurses station in the main hallway.

      2. If the Subject has sustained any injury and a physician is not available in the hallway, call the emergency room and request help.

      3. Page the GE field engineer and call any of the BIAC faculty or Thomas Boehringer so that they can determine if the magnet must be quenched.

      4. Refer to procedures in SOP102: Adverse Events.

    4. The Subject is trapped in the bore of the magnet by an object, or is pinned to the magnet by a metal object that cannot be moved, and is unconscious and/or has sustained a life threatening injury.

      The procedures below involve quenching the magnet to remove its magnet field. This involves venting the liquid helium and takes several minutes to complete. Quenching a magnet may result in serious damage to the MRI system, and therefore should only be performed if the Subject has sustained a life threatening injury and is trapped by the magnetic field and cannot be otherwise removed. Please refer to SOP103: Hardware Emergencies for more information about a magnet quench.

      1. Press the red quench button in the Magnet Room or Console Room. This will dissipate the magnetic field and allow the object to be removed and the Subject freed.

      2. It will take 3-4 minutes for the quench to complete. In this interval, summon help from the nurses station in the main hallway.

      3. If a physician is not available in the immediate area, call the emergency room and request help.

      4. Once medical help has arrived to tend to the Subject, page the GE field engineer and call any of the BIAC faculty or Thomas Boehringer.

      5. After medical staff have attended to the Subject, refer to procedures in SOP102: Adverse Events.

SOP