How to safely introduce critically monitored patients into an MRI room was the challenge posed at the General Hospital of Alicante (HGA). To address this, SIMIA LAB, the HGA’s simulation laboratory, trained healthcare personnel through various exercises in the use of monitors compatible with the room’s high magnetic field. This process is part of what is known as ‘system testing simulation’. To make the simulation more realistic, a silicone mask from Emulant was used on an actor.
SIMIA LAB designed and executed a series of simulated scenarios with real MRI-compatible monitors, alongside the recreation of a critical patient care circuit requiring MRI studies. In this context, monitors play a crucial role due to the vulnerable nature of these patients, but their implementation must adhere to the strict safety standards required in an MRI suite.
Challenges and Proposed Solution
The main challenge was introducing the monitors into the MRI suite and maintaining continuity in monitoring the patient within the MRI room. To prevent risks, the most important step was completing a safety checklist, with several considerations before, during, and after the medical simulation. Following the training exercise, protocols and procedures were adjusted to ensure maximum protection throughout the process.
The ventilated and monitored critical patient presented another challenge in creating a simulated scenario.
How was this resolved?
A simulated patient, played by an actor, was fitted with a hyper-realistic Emulant overlay. This allowed for the installation of several devices, including a nasogastric tube, placed between the mask and the face of the actor’s face and finished in a balloon so they can see the rise of the chest, an orotracheal tube connected to a transport ventilator, and a central venous line. The distal end of the orotracheal tube was connected to a test lung, enabling real mechanical ventilator settings and simulating chest movements during ventilation.
This specific model lacked ECG connectors, as these are incompatible with the MRI unit.
Monitoring and Results
Monitoring was conducted using MRI-compatible electrodes placed on the actor’s bony areas, such as the shoulders, to capture ECG readings. A pulse oximetry sensor was also placed on the actor’s finger, allowing for real-time parameter monitoring.
Thanks to this simulation, the new MRI unit was successfully tested, the protocol was approved, and the hospital staff had the opportunity to prepare for the safest possible use of the MRI suite.
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HIGHLIGHTS
– Monitoring of critically ill patients undergoing MRI plays a crucial role, so standardized procedures and controls are required to meet the safety constraints of the MRI environment.
– Creating a critically ill patient was another challenge in this medical simulation. This was solved by placing an Emulant hyper-realistic mask on an actor.
