Patient safety
had already seen the plans and layout for the new MRI scanning room. I discussed the drawings with the architect, to ensure that the design accommodated the Ferroguard system components in a configuration that met the Trust’s requirements for patient and staff flow, and entry to the MRI room. The drawings were then relayed to the general contractor, who undertook the provisional pre-installation work, ready for us to complete the final install.” The ‘final install’ of a Metrasens
system, Simon Collinge explained, must take place right at the end of the building process, since the magnet needs to be ‘ramped’, and ‘at field’, in situ, for Metrasens to be able to set the sensitivity settings appropriately.
‘Back-to-back’ configuration Dr Hogg said of the new control room: “One of the major advantages of the MRI and CT configuration in the new building here inWinchester is that the scanners are installed back-to-back. This enables one control room to be used to control both systems – much more efficient for staff, and a major boost to clinical throughput, efficiency. and workflow. The new imaging building is first-class, something acknowledged not just by the clinicians, radiologists, and other staff using it, but equally by our patients.”
An interesting background In our discussions prior to the official opening, Simon Collinge also told me about the interesting background to Metrasens’ formation, and the development of its own particular ‘brand’ of FMD technology. He said: “Metrasens is a British company, founded in Malvern in 2005 by physicists. The founders had previously worked for the Government’s scientific spin-off, QinetiQ, and had been using ferromagnetic detection technology to discover submarines, and for humanitarian landmine detection, before adapting it to the medical field. The first sales of Metrasens FMD systems for the medical arena were in the UK and North America.
Inventor’s impetus “Today,” he continued, “the inventor of our technology, DrMark Keene, is our CTO. He was in the US, in 2001, when he heard an alarming story about a nine-year-old boy having been struck on the head by a stray oxygen cylindermistakenly carried into an MRI suite during the boy’s scan. The incident occurred when, on discovering a problemwith the oxygen supply to the room, a nurse, thinking she was ‘doing the right thing’, found the nearest oxygen cylinder, and brought it into the scanning room, without realising it was steel. TheMRImagnet effectively ‘grabbed ‘the cylinder, and it hit the young
The Ferroguard Guardian entry control system is designed to detect ferrous objects before the MRI ‘threshold’.
patient on the head. He tragically died a few days later. The legal ramifications lasted a considerable time.”
Preventing repeats With his background in magnetics and metal detection, Dr Keene surmised the idea of developing a technology that would prevent similar incidents, by alerting staff if a person approached the MRI scanning room with a stray ferrous object ‘on them’. Simon Collinge said: “Ferroguard has
evolved considerably in recent years, to closely address the operational aspects of the medical environment it is used within. We now have two wall-mounted systems for entry control – Ferroguard Guardian, and the newest version, Ferroguard Assure. These two products are located at the entrance to the MRI suite, or in the vicinity, to prevent significant inadvertent projectile accidents.” Ferroguard Screener, meanwhile, which sees the patient screened by standing, and then turning through 360 degrees, on a special mat, prior to subsequently proceeding through the Ferroguard sensor-poles to the MRI scanning room, is used to supplement existing patient screening policies within MRI facilities. The devices and components allowed in
any MRI room itself are, by necessity, very limited, Simon Collinge explained: “You will typically only have special monitoring devices, gas lines, and anaesthetic machines which can operate safely in the room at certain distances from the magnet itself.”
An investment in safety The new MRI and CT unit at the Royal Hampshire County Hospital had been fully operational for about four months at the time of the official opening in June, with the Metrasens system having been in full operation throughout.
Adrian Davies said: “Underlining the
value of ferromagnetic detection equipment, we know of a healthcare provider that installed a Metrasens system earlier this year that had three alerts of unwanted ferromagnetic material within 21 days of it ‘going live’. In one instance, a patient had a magnet for rheumatism in her underwear, which could have caused injury, while in the other two, involving a hairpin, and something in the patient’s pocket, there could have been artefacts in the scan, resulting in time-wasting re-starts, or re-scans.”
A stressful experience Given the general thoroughness of the pre-scan procedures, I asked Adrian Davies whether, in fact, most patients were not already well aware of the risk of ferromagnetic objects before they arrived for their scan. He said: “You have to remember that having such a scan can be stressful for the patient, so, although they go through a very well-thought out questionnaire with the radiographer, they may be elderly, get confused, or may simply not fully understand the meaning of, or reasons for, the questions.” According to data for English healthcare
facilities from the MHRA and Department of Health, the number of ‘reported actual and near miss projectile incidents’ in such facilities during MRI scans rose from 1 in 1995, to 5 in 2011. Data on of the number of reported incidents is held by the MHRA, which also produces and publishes guidance on the safe and proper operation and management of MRI scanning facilities. “However,” Simon Collinge told me, “it is acknowledged that only a small proportion of such incidents are reported, meaning that the true incidence is likely to significantly higher. New safety guidelines are currently, in fact, under consultation for review, and will include the latest guidance information on the use of FMDs in the construction of MRI facilities.
Guidance already available “There is already,” he said, “good guidance from the MHRA about how to construct an MRI unit safely and robustly. In the US, both the American College of Radiology, and the Joint Commission that accredits the majority of US hospitals, recommend installation of FMD equipment in all new MRI facilities, and this is being increasingly incorporated into individual States’ building codes. “We believe that the FMD technology
that Metrasens offers is market-leading, in terms of our superior sensor technology, its reliability and workflow efficiency, and the fact that the equipment represents an excellent, low-cost investment for any healthcare provider determined to maximise patient and staff safety within their MRI scanning unit.”
Health Estate Journal September 2013
75
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