MRI Imaging Out of Hours: Acute Spinal Trauma, RHCG

Requests for an emergency out of hours MRI scan must be made after assessment and discussion with appropriate senior team members

• Neurological assessment should be made by the clinical team responsible for the patient
  • This assessment should include consideration of patient suitability for MRI (i.e. safety/implants).
• The consultant in charge of the patient’s care must be aware of, and agree with, plans for discussion/scanning and transfer
• The patient should be discussed with the on call consultant paediatric neurosurgeon, to determine whether an out of hours scan will alter surgical management.
• The responsible clinical team will complete the request on Trakcare and contact the consultant paediatric radiologist on call to discuss the need for an out of hours MRI scan and whether the scan can be performed within RHC in a timely manner.
• The consultant paediatric neurosurgeon will be available to discuss the case further with the consultant paediatric radiologist on call, if required.
• For transfer to the Institute of Neurological Sciences (INS) for an emergency OOH scan, the paediatric radiologist will contact the neuro radiographer, and if required the neuroradiologist to arrange
  • The Neuro Radiographer is on site on shift at the QEUH imaging department and can be contacted by bleep (6174)

Currently these examinations will be performed in the INS. Future staffing and service changes may allow them to be undertaken in QEUH using the above process

There is no agreement or pathway to provide emergency radiology to patients under the direct care (ED or inpatient) of other hospitals – these patients should be transferred to the care of an appropriate RHC team for assessment prior to MRI referral

An electronic request should be placed on Trak as per standard procedure

It must contain all appropriate clinical and MRI safety information

The paediatric radiologist will vet the request on CRIS. They will provide a scanning protocol – where possible this should align with the INS protocols (see appendix)

The referrer must consider and complete the patient safety questionnaire with concerns or questions clarified with the MRI radiography team prior to transfer

• The safety checklist should be completed by an appropriate parent/guardian (in person or by phone)
• Adequate pain / symptomatic relief should be given prior to transfer
• Patient specific concerns (e.g. weight/infection status) must be clarified prior to transfer
• An interpreter should be available if required
• If MRI safety information is incomplete a risk assessment should be performed

The INS does not have paediatric medical/resus cover.

• Transfers must have appropriate medical/ nursing support in line with their medical status and be considered the equivalent of transfer to another hospital
• It is the responsibility of the referring team to arrange this – liaising with other RHC teams as required.
• Appropriate kit (e.g. SCRAM bag) should accompany the patient.
• Resus trolley equipment will be available in the INS department.
• In the event of a 2222 call, the RHC, not the INS or QEUH team should be specified

The scans will be reviewed and reported primarily by the paediatric radiologist who can ask for support/opinion from the on call neuroradiologist if required

The patient will return to the referring location and the paediatric radiologist will communicate the result to the referring teams