A unique feature of the newly unclo...

A unique feature of the newly uncloseed OR at the Seaman Family Magnetic Resonance (MR) Research middle Calgary, Alberta, Canada, is that it was originateed to house a moveable magnetic resonance imaging (MRI) order The system allows OR staff members to acquire serial MR images of neurosurgical patients before, during, and after surgical intervention--an innovative conception that has been unparalleled elsewhere.

Nursing team members at Seaman Family MR Research middle point in consultation with MR adroits from the National Research Council of Canada, perform the operations indicated ined safety standards and protocols for using this highly specialized combination of parts to form a whole addressing issues involving instrumentation, equipment, intraoperative draping, and the maintaining of a core nursing team. Based in succession the system's initial setup and unique experience with its first 48 patients, this article provides pertinent guidelines for rendering safe perioperative care in an OR that houses a moveable magnet.

MAGNETIC RESONANCE TECHNOLOGY

Magnetic resonance imaging is the preferr regularity for diagnosing diseases that affect the central nervous combination of parts to form a whole (CNS) or cranial base.(1) Until lately it was impossible to provide surgeon with updated MR images of a patient's brain during surgery(2) Intraoperative MRI was barely a dream; today, however, it is a reality. Using cutting-edge technology, the moveable intraoperative MRI order allows surgeons to continue using neurosurgical techniques and instrumentation and, at the same time, obtain updated, high-resolution images at any point during surgery (Figure 1) This ability to provide intraoperative images is important for the two ensuring quality and determining the issue of surgery on brain construction and function.

[Figure 1 ILLUSTRATION OMITTED]

Critical composing A critical component of the MRI classification is the magnet. The moveable intraoperative MRI magnet at the Seaman Family MR Research midmost point is 1.5 m in duration and has a free bore of 62 cm The puissance of this magnet is tremendous--it is 30000 times stronger than the magnetic held of the earth.(3) To contain its magnetic field and eliminate the ne for armor shielding in the walls of the OR, the magnet is actively shielded. This means that, within the magnet, a secondary magnetic coil of opposite polarity is outside of the main magnetic coil. The secondary coil greatly shapes the magnetic fringe field that widens into the area surrounding the magnet.

phlogiston atoms. The human body comprises billions of atoms, which are constantly spinning. Each atom contains a north and southern pole, enabling each to have its admit magnetic field.(4) When the patient is placed within the bore of the magnet, the atoms align parallel or antiparallel to the larger magnetic field. inflammable air atoms are used to obtain MRI because they are the greatest in number abundant in the body. As the inflammable air atoms align within the visible form [i]or[/i] frame they precess or spin like a top. Using a radiofrequency (RF) coil, RF waves then are transmitted to the choiceed area of the body to obtain a signal from the phlogiston atoms. When the RF waves are transmitted, the phlogiston atoms are flipped or excited onto a plane that is perpendicular to the main magnetic field. Within milliseconds, the atoms relax back into a plane that is parallel with the magnetic field. As the atoms relax, they emit a signal, which is discovered and transformed into an image by dint of computers. Tissues with different concentrations of phlogiston atoms relax at different rates; thus, they display up differently on the scan and provide the contrast between different anatomical conformations within the brain.

SAFETY CONSIDERATIONS

Performing surgery near a high magnetic field pos an interesting challenge for OR team members.

Magnetic pluck The invisible magnetic force of the MRI plan is strong enough to twitch mop buckets, stretchers, and heavy-duty floor dolts into the bore of the magnet--it can level turn oxygen tanks into flying projectiles. Serious injury or death can present itself from being struck with as it was objects. Accordingly, personal items similar as scissors, loose change, pagers, pins, and identification badges are strictly forbidden in this OR.

Electromagnetic devices. The magnetic field also can interfere with electromagnetic devices and cause serious damage to the internal constituents of pacemakers, inner ear implants, and neurostimulators.(5) Patients who have had previous surgeries, have had metal in their estimates or have implants are at risk and must be thoroughly covered before undergoing MRI. For example, a certain intracranial aneurysm clips are ferromagnetic (ie, of an abnormally high magnetic permeability); thus, patients with as it was clips are not placed within the high magnetic field as aneurysm tearing and fatal hemorrhage could result(6)

Gauss lines. To enhance safety, sum of two units sets of visible markings called gauss lines are positioned in succession the OR floor to indicate magnetic field vigor and remind staff members of safety cinctures (Figure 2). The first line is orange and acts as the five gauss line, indicating a relatively depressed magnetic field. The next marking is r and depicts the 50 gauss line, a higher magnetic field. The magnetic field power increases exponentially until it reaches 15000 gauss inside the bore of the magnet.