place of abode Study Program Experi...

place of abode Study Program Experiences with an intraoperative magnetic resonance imaging method in neurosurgery

The article "Experiences witty, an intraoperative magnetic resonance imaging plan in neurosurgery is the basis for this AORN Journal independent subject of attention The behavioral objectives and examination for this program sooner than prepared by Rebecca Holm, RN MSN CNOR, clinical editor, with consultation from Susan Bakewell, RN M education program professional, Center for Perioperative Education.

Participants receive feedback upon incorrect answers. Each applicant who prosperously completes this study will receive a certificate of completion. The deadline for submitting this subject of attention is Sept 30, 2007.

perfect the examination answer sheet and learner evaluation fix on pages 455-456 and mail with appropriate pay to

AORN Customer Service c/o domicile Study Program 2170 S Parker Rd Suite 300 Denver CO 80231-5711

or fax the information with a credit card number to (303) 750-3212

You also may access this family circle Study via AORN Online at http://www.aorn.org/journal/homestudy/default.htm.

BEHAVIORAL OBJECTIVES

After reading and studying the article forward intraoperative magnetic resonance imaging (MRI), succors will be able to

1 explain the basic general [i]or[/i] abstract notion of MRI,

2 discuss MRI body hardware components,

3 describe working in an intraoperative MRI environment, and

4 identify nursing responsibilities in the intraoperative MRI environment.

This program qualifieds criteria for CNOR and CRNFA recertification, as well as other continuing education requirements.

A minimum score of 70% in succession the multiple-choice examination is necessary to earn 39 contact hours for this independent study

Purpose/Goal: To educate perioperative fosters about using portable intraoperative magnetic resonance imaging during neurosurgery

Dianne Carter-Gentry, RN MSN FNP-BC is a part-time instructor at the University of Louisville institute of Nursing, Louisville, Ky, and a family succor practitioner.

Peter M Black, MD PhD pioneered the use of magnetic resonance imaging (MRI) equipment for surgical intervention in January 1994 at Brigham and Women's Hospital, Boston. (1) Several puzzles had to be resolved before MRI technology could be used favorably in the OR. For example, standard surgical instruments distorted the magnetic field created through the MRI machine, so nonmagnetic (eg titanium, plastic, glass) instruments had to be cause to growed Another problem encountered during these pioneering surgical actions was that movement was inhibited around the sum of two units large magnets on either side of the patient. (2) In spite of these significant obstacles, the use of intraoperative MRI in surgery has conclusioned in more precise neurosurgical interventions. (3)

ACQUIRING INTRAOPERATIVE MRI CAPABILITIES AT UNIVERSITY HOSPITAL

University Hospital, Zurich, Switzerland, was the third hospital in the world to acquire an render free of access interventional MRI system (Figure 1) This prototype had a vertical gap in its magnet that provided physical space in which surgeon performed surgical performances Surgeons began using this unit in mid 1996 (1) by the agency of the end of 2000, 142 stereotactic processs had been performed, of which 114 were brain biopsy conducts and 28 were craniotomies for tumor excision and other related neurosurgical procedures

[FIGURE 1 OMITTED]

In July 2000 an improved archetype was installed at University Hospital. After the machine was installed, a third operating theatre was expanded in the neurosurgery department at University Hospital.

in what manner DOES MRI WORK?

An intraoperative MRI connected view is not limited to electronics or machinery; it also includes the surgical environment in which it functions. This surgical environment consists of the physical nature of the OR, the surgical transactions performed, and training of personnel required to operate the system

It is vital that all surgical team members understand in what manner an MRI machine works.

Human tissue is made up of atoms. inflammable air the most common atom in the human material part is found in both water and fat. A magnetic resonance (MR) image is based almost exclusively upon the study of hydrogen protons. An MRI machine is a sophisticated radio transmitter and receiver that creates radiowave spirit which is absorbed by corpse tissue. When radio waves (ie, electromagnetic waves at a particular radio common occurrence [RF]) are applied to inflammable air protons, the protons gain animal spirits and spiral out of steady-state orientation. The frequent occurrence at which this occurs is called resonance. (3)

When the radio-wave commonness causing proton excitation is remov the protons relax and turn back to their steady-state orientation. This relaxation proces takes time and is unable to exist without on the magnitude of the tissue ultimate particle s and the surrounding biological composition. The sharp image contrasts obtained on an MRI machine are the be the effect of accurately measuring different tissue emblems with different relaxation times. More specifically, protons and phlogiston nuclei in the body are like small magnets that are oriented in random directions below normal conditions. During neurosurgical MRI, the patient's head is placed in a lusty magnetic field, and a small portion of the patient's protons will align in the same direction as the magnetic field. This small population of protons absorbs and subsequently releases radio-wave efficacy which produces the MR image. (4)