Harbor:STAT MRI - Revision history

Bchap23: /* Policy 367b STAT MRI's */

2025-06-02T23:51:49Z

Policy 367b STAT MRI's

← Revisión anterior		Revisión del 23:51 2 jun 2025
Línea 25:		Línea 25:
	* STAT MRI may be requested by '''attending only''' from the following services (EM, Trauma, Neuro, Neuro Surg, Neuroradiology, Critical Care)		* STAT MRI may be requested by '''attending only''' from the following services (EM, Trauma, Neuro, Neuro Surg, Neuroradiology, Critical Care)
	* STAT when high likelihood that the MRI finding will '''result in an emergent procedural or operative intervention'''		* STAT when high likelihood that the MRI finding will '''result in an emergent procedural or operative intervention'''
	** '''ED or trauma attending should call the MRI tech''' or the radiology resident who will notify the MRI tech
	** '''Notify charge RN''' who will then notify the house supervisor
	** Place Communication Order for "ok off monitor" if appropriate
	** '''''Patient's room nurse should complete the MRI safety form''''': https://emedharbor.labiomed.org/private/Contact%20Info/ED%20Documents/HUCLA%20Safety%20Screening%20Form%20English%20and%20Spanish%2011-2018.pdf
	** If the ordering provider is not the approving attending, the '''ordering provider should document the approving attending’s name in the comments section of the MRI order'''		** If the ordering provider is not the approving attending, the '''ordering provider should document the approving attending’s name in the comments section of the MRI order'''
	** The MRI tech will notify the patient's RN when MRI is ready for the patient		*** '''ED or trauma attending should call the MRI tech''' or the radiology resident who will notify the MRI tech
	** There is no STAT process for Downey open MRI. Please discuss with the requesting team about alternative options/stability for these patients.		*** '''Notify charge RN''' who will then notify the house supervisor
			*** Place '''Communication Order for "ok off monitor"''' if appropriate
			*** Patient's room nurse should help the patient '''complete the MRI safety form'''; physician must sign if the patient is unable
			*** The MRI tech will notify the patient's RN when MRI is ready for the patient
			* There is no STAT process for Downey open MRI. Please discuss with the requesting team about alternative options/stability for these patients.

	===Policy 367B: Priority for the portable MRI will be given to the following groups of patients===		===Policy 367B: Priority for the portable MRI will be given to the following groups of patients===

Bchap23: /* Policy 367b STAT MRI's */

2025-06-02T23:46:17Z

Policy 367b STAT MRI's

← Revisión anterior		Revisión del 23:46 2 jun 2025
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	** '''Notify charge RN''' who will then notify the house supervisor		** '''Notify charge RN''' who will then notify the house supervisor
	** Place Communication Order for "ok off monitor" if appropriate		** Place Communication Order for "ok off monitor" if appropriate
			** '''''Patient's room nurse should complete the MRI safety form''''': https://emedharbor.labiomed.org/private/Contact%20Info/ED%20Documents/HUCLA%20Safety%20Screening%20Form%20English%20and%20Spanish%2011-2018.pdf
	** If the ordering provider is not the approving attending, the '''ordering provider should document the approving attending’s name in the comments section of the MRI order'''		** If the ordering provider is not the approving attending, the '''ordering provider should document the approving attending’s name in the comments section of the MRI order'''
	** The MRI tech will notify the patient's RN when MRI is ready for the patient		** The MRI tech will notify the patient's RN when MRI is ready for the patient

Bchap23: /* Policy 367b STAT MRI's */

2025-06-02T23:41:37Z

Policy 367b STAT MRI's

← Revisión anterior		Revisión del 23:41 2 jun 2025
Línea 27:		Línea 27:
	** '''ED or trauma attending should call the MRI tech''' or the radiology resident who will notify the MRI tech		** '''ED or trauma attending should call the MRI tech''' or the radiology resident who will notify the MRI tech
	** '''Notify charge RN''' who will then notify the house supervisor		** '''Notify charge RN''' who will then notify the house supervisor
			** Place Communication Order for "ok off monitor" if appropriate
	** If the ordering provider is not the approving attending, the '''ordering provider should document the approving attending’s name in the comments section of the MRI order'''		** If the ordering provider is not the approving attending, the '''ordering provider should document the approving attending’s name in the comments section of the MRI order'''
	** The MRI tech will notify the patient's RN when MRI is ready for the patient		** The MRI tech will notify the patient's RN when MRI is ready for the patient

Bchap23: /* Ordering STAT MRI */

2025-03-24T17:41:56Z

Ordering STAT MRI

← Revisión anterior		Revisión del 17:41 24 mar 2025
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	## If unable to get a response during these hours, call the MRI center at x64800		## If unable to get a response during these hours, call the MRI center at x64800
	# '''''After hours: call the MRI tech 3xx-218-2379''''' (rings 6x, voicemail has back-up numbers listed - please leave voicemail)		# '''''After hours: call the MRI tech 3xx-218-2379''''' (rings 6x, voicemail has back-up numbers listed - please leave voicemail)
	## If no answer, call 562-~~8o3~~-~~37o2~~ for the Lead Tech (Jeremy) - please leave voicemail		## If no answer, call 562-455-7o21 for the Lead Tech (Jeremy) - please leave voicemail
	### If no response, try again in 10 minutes		### If no response, try again in 10 minutes
	#### Last resort, call 3xx-666-9625 for Manager (Bernadette) - please leave voicemail		#### Last resort, call 3xx-666-9625 for Manager (Bernadette) - please leave voicemail

Bchap23: /* Ordering STAT MRI */

2025-03-17T06:30:52Z

Ordering STAT MRI

← Revisión anterior		Revisión del 06:30 17 mar 2025
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	==Ordering STAT MRI==		==Ordering STAT MRI==
	*[https://secure2.compliancebridge.com/lacdhs/DHSpublic/index.php?fuseaction=header.download&policyID=18169&descriptor=header1&doc=367B-Magnetic_Resonance_Imaging_Rev_12-21.pdf Policy 367b]		*[https://secure2.compliancebridge.com/lacdhs/DHSpublic/index.php?fuseaction=header.download&policyID=18169&descriptor=header1&doc=367B-Magnetic_Resonance_Imaging_Rev_12-21.pdf Policy 367b]
	* The decision to order a STAT MRI will be made after discussion with an attending physician ~~AND for which '''MRI results will alter the current treatment plan (including admission vs discharge decisions''' - Drs. Lewis, Mahajan, & Munn 4/2018)~~; external services may be consulted, but their "permission" is not necessary to order the study		* The decision to order a STAT MRI will be made after discussion with an ED attending physician; external services may be consulted, but their "permission" is not necessary to order the study
	* '''PLEASE RELAY TO THE MRI TECH if the study needs to be done IMMEDIATELY or can wait until 7am'''		* '''PLEASE RELAY TO THE MRI TECH if the study needs to be done IMMEDIATELY or can wait until 7am'''
	*Once the MRI is ordered		*Once the MRI is ordered
	# ~~'''''7a-7p, Monday to Friday''''': call~~ the MRI ~~building '''''x64800'''''~~; ~~Rosalinda on~~-~~site manager~~		# Call the Mobile MRI x64899 Mon - Fri 7am - 11pm; Sat, Sun, & county holidays 7am - noon
	~~## Mobile MRI x64899 ... call the MRI building (x64800) for any weekday scheduling questions/updates~~		## If unable to get a response during these hours, call the MRI center at x64800
	### If unable to get a response during ~~daytime~~ hours, call the ~~manager~~ at ~~3xx-666-9625~~		# '''''After hours: call the MRI tech 3xx-218-2379''''' (rings 6x, voicemail has back-up numbers listed - please leave voicemail)
	# '''''After hours: MRI tech 3xx-218-2379''''' (rings 6x, voicemail has back-up numbers listed - please leave voicemail)		## If no answer, call 562-8o3-37o2 for the Lead Tech (Jeremy) - please leave voicemail
	## If no answer, call ~~3xx~~-~~803~~-~~3702~~ (please leave voicemail)		### If no response, try again in 10 minutes
	### If no response, ~~call 3xx-938-8553 for Chief Tech (Daisy) - please leave voicemail~~
	#### Last resort, call 3xx-666-9625 for Manager (Bernadette) - please leave voicemail		#### Last resort, call 3xx-666-9625 for Manager (Bernadette) - please leave voicemail
	##### If still no response after 15 minutes, call Dr. Chappell's cell		##### If still no response after 15 minutes, call Dr. Chappell's cell
	* Expected response time is ~~1 hour~~ from contact to arrival (Trauma Criteria - CD 11-46, ACS COT VRC)		* Expected response time is less than 2 hours from contact to arrival (Trauma Criteria - CD 11-46, ACS COT VRC)

	===The tech will need the following information from the ED===		===The tech will need the following information from the ED===

Bchap23: /* Policy 367b REDLINE */

2025-03-17T00:15:34Z

Policy 367b REDLINE

← Revisión anterior		Revisión del 00:15 17 mar 2025
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	===[https://lacounty.sharepoint.com/:b:/r/sites/DHS/Harbor_PP/Harbor-UCLA%20Medical%20Center%20Policies%20and%20Procedures/367B-Magnetic%20Resonance%20Imaging%20-%20MRI%20Rev%2010-20.pdf?csf=1&web=1&e=EMB0Ph Policy 367b ~~REDLINE~~]===		===[https://lacounty.sharepoint.com/:b:/r/sites/DHS/Harbor_PP/Harbor-UCLA%20Medical%20Center%20Policies%20and%20Procedures/367B-Magnetic%20Resonance%20Imaging%20-%20MRI%20Rev%2010-20.pdf?csf=1&web=1&e=EMB0Ph Policy 367b STAT MRI's]===
	* STAT MRI may be requested by '''attending only''' from the following services (EM, Trauma, Neuro, Neuro Surg, Neuroradiology, Critical Care)		* STAT MRI may be requested by '''attending only''' from the following services (EM, Trauma, Neuro, Neuro Surg, Neuroradiology, Critical Care)
	* STAT when high likelihood that the MRI finding will '''result in an emergent procedural or operative intervention'''		* STAT when high likelihood that the MRI finding will '''result in an emergent procedural or operative intervention'''

Bchap23: /* Policy 367B: Priority for the portable MRI will be given to the following groups of patients */

2025-03-16T20:36:57Z

Policy 367B: Priority for the portable MRI will be given to the following groups of patients

← Revisión anterior		Revisión del 20:36 16 mar 2025
Línea 38:		Línea 38:

	*WITH one of the following documented indications		*WITH one of the following documented indications
	** '''~~REDLINE~~''':		** '''STAT''':
	*** Acute spinal cord injury		*** Acute spinal cord injury
	*** Suspected spinal instability		*** Acute spinal cord compression or ischemia
	*** Evaluation for cerebral hemorrhage (may need IR for coiling)		*** Suspected epidural abscess or discitis
	*** Acute ~~stroke symptoms to determine if thrombectomy candidate~~		*** Acute cauda equina/conus medullaris syndrome
	*** Suspected spinal compression or ischemia		*** Concern for CNS tumor or abscess with acute change in neurological status (inadequately visualized on contrast-enhanced CT)
	*** ~~Concern for~~ epidural [[abscess]] or discitis		*** Assessment of VP shunt malfunction (with contraindication to CT)
	*** ~~Concern for acute/subacute~~ cauda equina/conus medullaris syndrome		*** Acute stroke symptoms with a non-diagnostic head CT
	*** Concern for CNS tumor or [[abscess]] with acute change in neurological status		*** Evaluation for cerebral hemorrhage (that may require IR for coiling)
	*** Assessment of VP shunt malfunction		*** Pregnant female for appendicitis (with equivocal physical examination and non-diagnostic ultrasound)
	*** ~~Emergent arterial imaging~~ (~~aortic dissection, aneurysm leak, etc.~~) ~~when contraindication to IV CT contrast~~		*** Arterial imaging (aortic dissection, aneurysm leak, etc.) with contraindication contrast-enhanced CT.
	*** Pregnant female with equivocal physical examination and ultrasound ~~for appendicitis~~		** '''Urgent'''
	*** ~~Urgent Magnetic Resonance Cholangiopancreatopgraphy~~ (~~MRCP~~)		*** Suspected occult hip fracture (CT negative but no longer weight-bearing)
	** '''~~STAT~~''':
	*** ~~Acute stroke symptoms with non~~-~~diagnostic head CT (admit to neuro stroke team~~)
	*** Suspected acute/subacute myelopathy or focal neurological deficit
	*** Suspected meningitis, encephalitis, or CNS vasculitis		*** Suspected meningitis, encephalitis, or CNS vasculitis
			*** Urgent Magnetic Resonance Cholangiopancreatography (MRCP) for choledocholithiasis

	==Ordering STAT MRI==		==Ordering STAT MRI==

Bchap23: /* Policy 367b REDLINE */

2025-03-16T20:32:18Z

Policy 367b REDLINE

← Revisión anterior		Revisión del 20:32 16 mar 2025
Línea 23:		Línea 23:

	===[https://lacounty.sharepoint.com/:b:/r/sites/DHS/Harbor_PP/Harbor-UCLA%20Medical%20Center%20Policies%20and%20Procedures/367B-Magnetic%20Resonance%20Imaging%20-%20MRI%20Rev%2010-20.pdf?csf=1&web=1&e=EMB0Ph Policy 367b REDLINE]===		===[https://lacounty.sharepoint.com/:b:/r/sites/DHS/Harbor_PP/Harbor-UCLA%20Medical%20Center%20Policies%20and%20Procedures/367B-Magnetic%20Resonance%20Imaging%20-%20MRI%20Rev%2010-20.pdf?csf=1&web=1&e=EMB0Ph Policy 367b REDLINE]===
	* ~~REDLINE~~ MRI may be requested by '''attending only''' from the following services (EM, Trauma, IR, ~~NS, CTS~~, ~~Ortho~~, ~~& Neuro~~)		* STAT MRI may be requested by '''attending only''' from the following services (EM, Trauma, Neuro, Neuro Surg, Neuroradiology, Critical Care)
	* ~~REDLINE~~ when high likelihood that the MRI finding will '''result in an emergent procedural or operative intervention'''		* STAT when high likelihood that the MRI finding will '''result in an emergent procedural or operative intervention'''
	** '''ED or trauma attending should call the ~~radiology resident~~''' who will notify the MRI tech		** '''ED or trauma attending should call the MRI tech''' or the radiology resident who will notify the MRI tech
	** '''Notify charge RN''' who will then notify the house supervisor		** '''Notify charge RN''' who will then notify the house supervisor
	** ~~Timestamp~~ the ~~REDLINE request time~~ in the ~~medical record (write in~~ the order ~~comment and timestamp in your MDM/narrative charting)~~		** If the ordering provider is not the approving attending, the '''ordering provider should document the approving attending’s name in the comments section of the MRI order'''
	** The MRI tech will notify the patient's RN when MRI is ready for the patient		** The MRI tech will notify the patient's RN when MRI is ready for the patient
	** There is no ~~redline~~ process for Downey open MRI. Please discuss with the requesting team about alternative options/stability for these patients.		** There is no STAT process for Downey open MRI. Please discuss with the requesting team about alternative options/stability for these patients.


	===Policy 367B: Priority for the portable MRI will be given to the following groups of patients===		===Policy 367B: Priority for the portable MRI will be given to the following groups of patients===

Bchap23: /* MRI Hours */

2025-03-16T19:34:55Z

MRI Hours

← Revisión anterior		Revisión del 19:34 16 mar 2025
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	*** Monday - Friday 7a-11p		*** Monday - Friday 7a-11p
	*** Weekends/holidays 7a-noon		*** Weekends/holidays 7a-noon
	** The MRI tech will only come in after-hours for ~~REDLINE MRI's and select~~ STAT MRI's		** The MRI tech will only come in after-hours for STAT MRI's
	*** ~~Redline~~ is defined as changing decision for intervention (operative, treatment, etc.)		*** STAT is defined as changing a decision for intervention (operative, treatment, etc.) and should be completed within 2 hours of being ordered
	*** Please be judicious with the timing of calling in the MRI tech - if not ~~a redline~~, the tech can perform first thing in the AM, now 7 days a week; if you are unclear whether or not to call in the tech, please discuss with the AOD.		*** Please be judicious with the timing of calling in the MRI tech - if not STAT, the tech can perform first thing in the AM, now 7 days a week; if you are unclear whether or not to call in the tech, please discuss with the AOD.

Bchap23: /* Outpatient MRI */

2025-03-16T19:32:36Z

Outpatient MRI

← Revisión anterior		Revisión del 19:32 16 mar 2025
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	==Outpatient MRI==		==Outpatient MRI==
	* For DHS patients who do not have COVID symptoms, if a consultant feels a MRI can be ordered within 72 hours which can avoid an admission or calling in the MRI tech on off hours, here is the process:		* For DHS patients who do not have COVID symptoms, if a consultant feels a MRI can be ordered within 72 hours which can avoid an admission or calling in the MRI tech on off hours, here is the process:
	** Have the RN complete the MRI checklist to ensure no contra-indication to MRI; if there are any questions about a contraindication, call the MRI center at x64800 or MRI tech 3xx-218-2379 ~~after hours~~		** Have the RN complete the MRI checklist to ensure no contra-indication to MRI; must be signed by a physician
			*** If there are any questions about a contraindication, call the MRI center at x64800 or MRI tech 3xx-218-2379
	** Consultant orders the desired MRI ("Order for future visit", in approximately 2 days, grace period +/-2 days)		** Consultant orders the desired MRI ("Order for future visit", in approximately 2 days, grace period +/-2 days)
	*** '''consider XR Orbits''' to avoid potential delays in obtaining imaging		*** '''consider XR Orbits''' to avoid potential delays in obtaining imaging
Línea 10:		Línea 11:
	* The '''consultant who orders the study is responsible to f/up on the study'''; alternately can '''message empaneled PCP and "save to chart" '''		* The '''consultant who orders the study is responsible to f/up on the study'''; alternately can '''message empaneled PCP and "save to chart" '''
	* OOP patients should be referred to their PCP/health network for imaging		* OOP patients should be referred to their PCP/health network for imaging


	==MRI Hours==		==MRI Hours==