Mock MRI Scanners to Reduce Anesthesia UseMock MRI Scanners to Reduce Anesthesia Use https://pediatricsnationwide.org/wp-content/themes/corpus/images/empty/thumbnail.jpg 150 150 Katie Brind'Amour, PhD, MS, CHES Katie Brind'Amour, PhD, MS, CHES https://pediatricsnationwide.org/wp-content/uploads/2021/03/Katie-B-portrait.gif
- October 28, 2014
- Katie Brind'Amour, PhD, MS, CHES
Initial research supports the use of MRI practice sessions and mock scanners to avoid sedation and alleviate patient and parent anxiety before an MRI. Studies exist for populations such as patients with ADHD and diabetes, but to date no studies appear to investigate the use of a mock MRI machine for young children with a wide range of health conditions and imaging needs.
This deficit is something Child Life Specialists Amy LeRoy, CCLS, and Rebecca Hicks, CCLS, are working to correct. The pair works on the radiology team at Nationwide Children’s Hospital and has acquired a mock MRI scanner in the hopes that the machine will reduce the need for sedation and improve patient experience. In the first two months of using the machine, the pair performed over 35 mock scans and successfully helped 24 of those children avoid sedation.
“Our goal right now is to evaluate whether the mock scanner is truly effective in helping us prepare patients to successfully complete their MRI without sedation,” says Hicks, who has worked as a child life specialist at Nationwide Children’s for two years. “But it is also a useful tool for assessing whether a patient cannot complete the scan without sedation. If we have a patient who isn’t afraid of the scanner or the loud noises but just isn’t able to hold still, we can inform the MRI techs and keep moving with the sedation plan.”
The team regularly uses the mock scanner to help prepare children for the actual procedure. After this advanced exposure to the machine, the team has frequently collected valid images without sedation on children as young as 6 years of age, and has also completed successful, unsedated scans on two 5-year-olds.
“It’s gratifying that by taking a little bit of extra time to prepare and educate children, they are able to lie still and tolerate very loud noises for a significant amount of time,” says LeRoy, a child life specialist for five years. “I think some parents are pleasantly surprised that their children are able to do it, too.”
The mock scanner may be especially useful for children in need of multiple MRIs, the pair says. By learning to master the MRI experience, these children can avoid repeated sedations, non per os (NPO) and the longer post-scan recovery times from the anesthesia.
When a patient is scheduled for an MRI, the child life specialists call the family in advance to discuss the mock scanner option with parents based on the child’s age, scan type and health condition. In cases of ADHD or developmental delays, very lengthy scans, or conditions such as scoliosis that can cause pain when lying supine, the team bases their offer of the mock scan on parents’ assessments of their child’s ability to lay still.
Although some patients still decide they want sedation for the actual scan, many children — and parents — thrive on the practice opportunity, the specialists say.
“Spending some time with the mock scanner has empowered parents to take an active role in coaching their child through the experience and really providing encouragement,” Hicks says. “Sometimes parents are unsure of how they can support their child in the hospital setting, and this is a more relaxed setting for them where they feel they can really be involved.”
The hospital imaging staff are pleased with the scanner’s initial impact, as well.
“We previously would prepare patients utilizing pictures, a video of our MRI machines and verbal preparation, but some kids still didn’t grasp what it would really be like and how still they really needed to stay,” LeRoy says. “Our MRI technologists are happy that we are able to use our motion tracking device in the mock scanner to actually make sure kids feel comfortable and can hold very still. And obviously, they understand the risks of sedation and are happy to avoid them when possible.”
The two specialists are collecting data on the children’s ages, conditions, types of scans, sedation use and eventual completion of a successful scan for more formal analyses, and their preliminary experiences show promise for the use of the mock MRI machine.
“We hope that we can educate patients about MRI scans, assess their tolerance of the noises and the large machine, and help them remain still for a real scan,” LeRoy says. “Our prediction is that the mock scanner will help us to accomplish that goal.”
- Epstein JN, Casey BJ, Tonev ST, Davidson M, Reiss AL, Garrett A, Hinshaw SP, Greenhill LL, Vitolo A, Kotler LA, Jarrett MA, Spicer J. Assessment and prevention of head motion during imaging of patients with attention deficit hyperactivity disorder.Psychiatry Research. 2007 May 15, 155(1):75-82.
- Barnea-Goraly N, Weinzimer SA, Ruedy KJ, Mauras N, Beck RW, Marzelli MJ, Mazaika PK, Aye T, White NH, Tsalikian E, Fox L, Kollman C, Cheng P, Reiss AL; Diabetes Research in Children Network (DirecNet). High success rates of sedation-free brain MRI scanning in young children using simple subject preparation protocols with and without a commercial mock scanner–the Diabetes Research in Children Network (DirecNet) experience. Pediatric Radiology. 2014 Feb, 44(2):181-6.