Hoʻopaʻa ʻia ʻo MRI Magnet Projectile, Pihi Quench Emergency, a me Cryogen Vent Failure¶

Hoʻohana ʻia nā mea ʻimi kiʻi hoʻonaninani magnetic (MRI) me ka hoʻohana ʻana i nā electromagnets superconducting i helu nui ʻia ma 1.5 Tesla (15,000 Gauss) a i ʻole 3.0 Tesla (30,000 Gauss), me nā ʻāpana noiʻi kūikawā a hiki i 7.0 Tesla (70,000 Gauss). He 30,000 a hiki i 60,000 manawa oi aku ka ikaika o kela kahua magnetic static (\(B_0\)) ma mua o ke kahua magnetic maoli o ka Honua, a e mau ana ia ** ho'ā i nā hola 24 o ka lā, 365 lā o ka makahiki**, ʻoiai ke pio ʻia ka console scanner, ma waena o nā maʻi, a i ʻole i ka wā o ka ʻeleʻele o ka haukapila. Inā lawe mai ka mea pane i pale ʻole ʻia, kahu mālama, a i ʻole kekahi lālā o ka ʻohana i ka ferromagnetic steel oxygen cylinder, hale kaʻa ulia pōpilikia, noho huila kumu ʻole MR, pale papahele, a i ʻole nā ʻāpana ʻāpana ʻeha kila ma waena o ka paepae i MRI Zone IV (ke keʻena magnet), ʻo ka spatial spatial magnetic gradient kokoke i ka puka o waho e hopu ai i ka lima o ka pahu hao. pūnana me he pūkuniahi lā ma 45 a 70 mau kilomita i ka hola (28 a 45 mau mile i kēlā me kēia hola) me nā haneli a mau tausani kilokani o ka ikaika huki.

Ke hoʻopaʻa ʻia ke kanaka i loko o ka lua MRI ma waena o ka hale magnet a me kahi kauā kila, ka huila, a i ʻole ka pahu oxygen, ʻaʻohe helu o nā mea hoʻopakele ikaika e hiki ke huki i kēlā mea kila ma ka lima, a ʻo ka lawe ʻana i nā pahu kila kila a i ʻole nā ​​koʻi ahi i loko o ka lumi e hana wale i nā projectiles lethal hou. ʻO ka hoʻokuʻu ʻana i ke kanaka e hoʻoweliweli ana i ke ola i loko o ka lua e pono ai ke kaomi ʻana i ka pihi ʻulaʻula Emergency Magnet Rundown (Quench) Button, nāna e hoʻopau i ka superconductivity o nā coils magnet a hoʻolapalapa a hiki i ka 1,500 a 2,000 liters (400 a 530 galani) o ka wai helium liʻiliʻi 592 degere. Fahrenheit). Eia nō naʻe, inā paʻa ʻia ka paipu hoʻoheheʻe cryogenic o waho e ka hau, nā pūnana manu, a i ʻole ka haki ʻana i ka disc, e hoʻonui ʻia ka helium wai paila i ka 757 manawa i ka leo pololei i loko o ka lumi hoʻopaʻa ʻia, e hana ana i kahi keʻena overpressurized, maloʻo, hoʻemi ʻia ka oxygen e paʻa ai ka poʻe e noho ana me ka paʻa ʻana i nā puka komo. ʻIke i ka wā e paʻi ai i ke pihi ʻulaʻula Electrical Emergency Power Off me ke pihi ʻulaʻula Magnet Quench, pehea e haʻalele ai i ka haki ʻana o ka paipu kinai ʻoki, a pehea e hoʻōla ai i ka mea maʻi i hopu ʻia ma ka neʻe ʻana iā lākou ** mai ka Zone IV i Zone III ** ma mua o ka lawe ʻana mai i ke kaʻa ulia a me ka defibrillator e hoʻopakele i nā ola; mālama i kou wahi helu pilikia mākaukau, a nānā ʻoki ʻia ka pahu pahu pahu kinoea i hoʻopaʻa ʻia a me nā leak cryogenic, asphyxiation wahi paʻa, a hypothermia and frostbite kōkua mua.

E hana i kēia i kēia manawa¶

1. ** ʻAʻole loa e komo i loko o ka lumi MRI scan (Zone IV) e lawe ana i kekahi mea kila a i ʻole mea metala ʻike ʻole ʻia, ʻoiai i ka wā o ka hoʻopaʻa ʻana i ka naʻau a i ʻole ke ahi. e wehe i nā kī āpau, nā pagers, nā kelepona, nā ʻoki, nā stethoscopes, nā pahu oxygen, a me nā pūke ahi SCBA ma mua o ka hele ʻana i ka laina pōʻino o ka papahele ʻulaʻula i ka Zone IV.
2. Inā komo ka mea maʻi i ka hopu ʻana i ka naʻau, hopu ʻana i ka hanu, a i ʻole anaphylaxis i loko o ka MRI scanner, MAI lawe mai i ke kaʻa pōʻino a i ʻole defibrillator i loko o ke keʻena scan, a MAI kinai i ka magnet. E kaomi koke i ka pihi home/release (a huki i ka lima mechanical table decoupling handle), e hoʻoheheʻe i ka mea maʻi ma luna o kahi MR-safe non-ferromagnetic gurney o Zone IV ** Zone o ** a i ʻole ʻo III. (wahi kali/paʻa) i loko o 15 a 30 kekona i hiki i ka hui code ke defibrillate a intubate palekana ma waho o ke kahua magnetic.
3. **E kaomi i ke pihi ʻulaʻula MAGNET QUENCH (Emergency Magnet Rundown) WALE no nā ulia pōpilikia ʻelua e ola a make paha: (a) ua paʻa kino ke kanaka a i ʻoki ʻia paha e kekahi mea ferromagnetic e kūʻē i ka magnet me ka hoʻoweliweli koke ʻana i ke ola a i ʻole (b) ke ahi hiki ʻole ke hoʻopaʻa ʻia i loko o ka lumi scan. (e like me ka paʻa o ka papahele a i ʻole ka noho huila kaʻawale) inā ʻaʻohe kanaka i ʻeha a paʻa paha; Hiki i kekahi hui lawelawe ʻenekinia ke hoʻopaʻa pono i ka magnet me ka ʻole e hoʻolapalapa i ka helium.
4. **E hoʻomaka koke ka Magnet Quench (inā paha i hoʻomaka ʻia e ke pihi a i ʻole e hana wale ʻia me ka leo nui a me ka leo ʻana), E HAʻEKE koke aku i kēlā me kēia kanaka mai ka lumi MRI scan. ʻO kahi paipu puka makani ʻāhaʻi a ālai ʻia e hoʻopiha i ka lumi me ke kinoea helium asphyxiating a me ke kaomi maikaʻi ma lalo o 30 kekona.
5. Inā hoʻopaʻa ʻia ka puka MRI e koli ana i loko mai loko mai e ke kaomi kinoea maikaʻi i ka wā o ka hoʻopio ʻole ʻia, e uhaʻi i ka puka aniani nānā lumi hoʻomalu i pale ʻia me ka keleawe me ka hoʻohana ʻana i kahi mea koʻikoʻi koʻikoʻi (e like me kahi noho alumini, mea kinai ahi keleawe, a i ʻole nā ​​​​pahu plastik) no ka hoʻomaha ʻana i ka puʻe a me ka puka ʻana o ka puka aniani.
6. No ke ahi uwila, uwea uwila, a i ʻole ke kī ʻana i nā kaʻa kaʻa kahi i hoʻopaʻa ʻole ʻia, e kaomi i ke pihi Electrical EMERGENCY POWER OFF (EPO) ma kahi o ka pihi Magnet Quench. Na ke pihi EPO e pepehi koke i nā mana uila 480-volt AC i nā mea hoʻonui gradient, radiofrequency.
7. **E kāhea i kāu hui code code a me ka helu pilikia kūloko (911 ma ʻAmelika Hui Pū ʻIa a me Kanada, 112 ma waena o ka European Union, 999 ma United Kingdom) a e ʻōlelo aku i ka hōʻea ʻana i nā mea kuni ahi a me nā mea lapaʻau ma ka puka o waho o ka Zone III e LIVE ka magnet MRI. ka hōʻea ʻana i nā mea pane ulia pōpilikia ma mua o ka hoʻokokoke ʻana i ka puka.

lāʻau hoʻoholo: MRI scan lumi pilikia pilikia¶

flowchart TD
    Start["Hoʻopilikia i loko a i ʻole a puni ka lumi ʻimi MRI (Zone IV)"] --> Scenario{"He aha ke ʻano pilikia e kū nei i kēia manawa?"}
    Scenario -->|"Code Lapaʻau Maʻi (Hoʻopaʻa ʻia ka Puʻuwai, Hoʻopaʻa ʻia, Hoʻohālikelike Hoʻohālikelike)"| MedCode["1. MAI lawe mai i ke kaa ulia, pahu kila O2, ai'ole AED i loko o ka Zone IV; 2. MAI kaomi i ke pihi Magnet Quench; 3. Wehe / hoʻokuʻu i ka papa maʻi a ʻōwili koke i ka mea maʻi i waho o ka Zone III/II; 4. E hoʻomaka i ka CPR a me ka hoʻōla piha ʻana i ka ACLS ma waho o ke kahua magnetic"]
    Scenario -->|"Huki ʻia ʻo Ferromagnetic i loko o ka lua makeke"| PinCheck{"Ua paʻi ʻia ke kanaka, ʻeha, a i ʻole ʻia paha?"}
    PinCheck -->|"ʻAe: ʻO ke kanaka i hoʻopaʻa ʻia me ka hoʻoweliweli ola"| QuenchNow["1. E hoʻohuli i ka pale plastik a e kaomi koke i ke pihi RED MAGNET QUENCH; 2. E kiaʻi i ka noe keʻokeʻo a i ʻole ka helium e uwē ana i loko o ka lumi (hiki ʻole ka puka makani); 3. Paʻa i ka mea metala kaumaha i ʻole e hāʻule i luna o ka mea maʻi ke hāʻule ke kahua (60 a 120 kekona); 4. Huki i ka mea i pepehiia a me ka mea maopopo a e haʻalele i ka lumi koke"]
    PinCheck -->|"ʻAʻole: Nā lako wale nō i paʻa (ʻaʻohe mea i paʻa)"| NoQuench["1. MAI kaomi i ke pihi Magnet Quench; 2. Mai ho'āʻo e ʻohi i nā mea me nā mea kila; 3. E hoʻokuʻu i ka lumi, e pani i ka puka, a e kāhea aku i ka ʻenekini hana MRI no ka hoʻokele ʻana i lalo"]
    Scenario -->|"Ka leo nui / ʻO ka noe keʻokeʻo / hoʻopau koke a i ʻole Cryogen Leak"| CryoLeak["1. E hoʻokuʻu koke i ka maʻi a me nā limahana mai ka Zone IV; 2. E ho'ā i ka lumi MRI Emergency Exhaust Fan hoʻololi i loko o ka lumi hoʻomalu; 3. Inā paʻa ka puka e koli ana i loko e ke kaomi lumi, e uhaʻi i ka puka makani e hoʻokuʻu i ke kaomi; 4. Mai komo hou i loko o ka lumi i piha i ka noe me ka SCBA (asphyxiation hazard)"]
    Scenario -->|"Uhi Uhi Uila, Coil Sparking, or Pinch Mechanical Table"| ElecEPO["1. E kaomi i ke pihi Electrical EMERGENCY POWER OFF (EPO) (NOT ke pihi Quench); 2. Huki i ka lima hoʻokuʻu papaʻaina mīkini lima a hoʻokuʻu i ka mea maʻi mai Zone IV; 3. E hoʻohana WALE i kahi mea kinai ahi keʻokeʻo/'ōmaʻomaʻo MR-Safe non-magnetic extinguisher inā loaʻa ke ahi liʻiliʻi."]

Physics o ka superconducting magnet: No ke aha e pio ole ai ke kahua¶

Ke kahua paʻakiki (\(B_0\)) kūʻē.¶

Hoʻokumu ka 1.5-Tesla a i ʻole 3.0-Tesla MRI scanner i kāna māla magnetic static nui (\(B_0\)) ma o ka holo ʻana i nā haneli amperes o ke au pololei ma o ka niobium-titanium (\(\text{NbTi}\)) uea superconducting i hoʻokomo ʻia i loko o **helium wai ma 4.2 Kelvin (minus 268.9000 Celsius / minus 268.9 ° C. cryostat. No ka niobium-titanium he **zero uila ke kū'ē ** i ka wai helium wela, ke hoʻokomo ka ʻenekinia i ke au i loko o ka wili i ka wā e hoʻokomo ʻia ai, e kaʻapuni kēlā ʻano i loko o kahi puka pani no ka pau ʻole me ka mana o waho. ʻOiai inā nalowale ka haukapila i ka mana waiwai nui a me nā mea hana hoʻihoʻi, e mau ana ka magnet i ka ikaika piha 1.5T a i ʻole 3.0T.

Hana like ʻelua mau mana mana ma luna o kekahi mea ferromagnetic (hao, carbon steel, nickel, cobalt, a me martensitic stainless steel) e komo ana i ka Zone IV:

1. Kuhi hoʻololi ʻana (e like me \(B_0\)): Huli ikaika ke kahua laʻa i ke koʻi lōʻihi o kahi mea kila e hoʻolikelike me nā laina ʻākau-hema o ka lua. ʻO nā ʻoki kila, nā wīwī, a i ʻole nā ​​kinikini oxygen e wili a hiki i ka 40 manawa o ke kaumaha o ka mea, e haki ana i kou paʻa ma mua o ka huki ʻana.
2. Ka ikaika hoihoi unuhi (ka hopena projectile missile, like me \(B_0 \times \frac{dB}{dx}\)): ʻO ka mea e huki ai i kahi mea kila ma ka lewa e like me ka missile, ʻo ia ka ** gradient magnetic field spatial** (\(\frac{dB}{dx}\)), ka wikiwiki o ka ikaika o ke kahua i kēlā me kēia kenimika kokoke i ka lua.
3. No ka mea, ua pale ikaika ʻia nā mea nānā MRI o kēia wā me nā wili ʻeha e mālama pono ai i nā ala o ka haukapila, hiki iā ʻoe ke kū ma ka puka Zone IV 3 mika (10 kapuaʻi) mai ka mīkini paʻa e paʻa ana i kahi pahu kila a manaʻo i ka zero pull. Ma 2 mika (6.5 kapuaʻi), ʻike ʻoe i kahi huki huki māmā 1-kilogram (2.2-paona).
4. Eia naʻe, hoʻopaʻa ka pale ikaika i ka neʻe ʻana o ke kahua holoʻokoʻa i ka hope 1.0 a 1.5 mika (3.3 a 5 kapuaʻi) ma waho o ka lua. ʻO ka lawe ʻana i hoʻokahi kapuaʻi hou i mua (30 a 50 kenimika / 12 a 20 ʻīniha) e ʻaʻa i ka "pali gradient." Ma lalo o ka hapalua kekona, lele ka ikaika huki mai 2 kilokani a hiki i 100 a 500 kilokani (220 a 1,100 paona), e haehae ana i ka mea mai kou mau lima mai ma 10 a 30 G a hoopa'i i ka lua ma 60 kilomita i ka hora (40 mile i ka hora).

ʻO ka ikehu kinetic a me nā ikaika pinning i loko o kahi lua 1.5T a me 3.0T¶

ʻO nā wahi palekana ACR MRI ʻehā a me ka holo ʻana i kahi code olakino ma waho o ka Zone IV¶

Na ka American College of Radiology (ACR) Manual on MR Safety (a me nā alakaʻi like MHRA a me RANZCR) hoʻokaʻawale i kēlā me kēia hale MRI i ʻehā mau ʻāpana:

• Zone I: Nā alanui halemai aupuni ma waho o ka MRI suite.
• Zone II: ʻO ka hoʻokipa ʻana, nā lumi ʻaʻahu, kahi e hoʻopaʻa ai i nā maʻi. ** ʻO ka ʻāpana II kahi o nā kaʻa ulia a me ka hōʻea ʻana i ke kahua lapaʻau.**
• Zone III: Paʻa paʻa paʻa ʻia ka ʻāpana hoʻomalu mana ma waho koke o ka lumi magnet. ʻO nā limahana i nānā ʻia a me nā maʻi i mālama ʻia ke komo i ka Zone III.
• Zone IV: ʻO ka MRI magnet lumi ponoi iho i pale ʻia, i hōʻailona ʻia me kahi hōʻailona "THE MAGNET IS ALWAYS ON" a me kahi laina pōʻino o ka papahele ʻulaʻula.

ʻO ka protocol step-by-step ke hoʻopaʻa inoa ka mea maʻi i loko o ka lua¶

Ke loaʻa ka mea maʻi i loko o ka tunnel MRI i ka hopu ʻana i ka naʻau, anaphylaxis like ʻole, a i ʻole ka hopu ʻana, ʻaʻole pono e holo wikiwiki nā hui code unscreened i loko o ka Zone IV me kahi kaʻa ulia kila, defibrillator, a i ʻole ke kila oxygen cylinder:

1. ** ʻAʻole loa e kinai i ka magnet no ka lāʻau lapaʻau, a ʻaʻole loa e lawe mai i nā mea hoʻōla i loko o ka Zone IV: ** ʻO ka hoʻopau ʻana e lawe i ** 60 a 180 kekona** a hiki i ka hoʻomake ʻana o ka helium, e hoʻopau i nā minuke koʻikoʻi i ka wā o ka hopu ʻana i ka naʻau.
2. E kaomi i ka pihi "Home / Rapid Eject" a i ʻole e huki i ka lima hoʻokuʻu mīkini lima:
3. Aia i kēlā me kēia papa MRI he manual mechanical decoupling pedal a lima paha e hoʻokuʻu ai i ka papa papa ma lalo o 2 kekona me ka ʻole o ka mana.
4. E hoʻoneʻe i ka mea maʻi ma luna o ka MR-Safe non-ferromagnetic aluminum/plastic stretcher i mālama ʻia ma waho o ka Zone IV.
5. E ʻōwili i ka mea maʻi i loko o ka Zone III a i ʻole Zone II a SLAM i ka puka o ka lumi magnet Zone IV i pani ʻia:
6. ʻO ka unuhi ʻana i ka mea maʻi mai ka lua i loko o ka Zone II e lawe ma lalo o 20 a 30 kekona.
7. E hana lima lima wale nō i ka hoʻopiʻi umauma ma ka ʻōwili MR-Safe stretcher oiai e neʻe ana; ike CPR.
8. Pani a hoʻopaʻa koke i ka puka Zone IV no laila ʻaʻole hiki i nā kauka a me nā poʻe lapaʻau ke hōʻea mai i loko o ka lumi magnet ola.
9. E hana piha i ka Advanced Cardiac Life Support (ACLS) ma ka Zone II: Aia ma waho o ka laina 5-Gauss me ka pani ʻana o ka puka magnet, e hoʻopili pono i nā pad defibrillator, laryngoscopes, a me nā pahu oxygen maʻamau.

ʻElua mau pihi ʻulaʻula ʻokoʻa: ʻEliila Hoʻopiʻi Manaʻo (EPO) vs. Magnet Quench¶

Loaʻa i kēlā me kēia MRI suite ** ʻelua mau pihi pilikia ʻulaʻula like ʻole** ma ka paia. ʻO ka huikau ʻana iā lākou ʻaʻole hiki ke hoʻokuʻu i kahi mea i hoʻopaʻa ʻia a i ʻole e hoʻolapalapa ʻia i ka ʻauʻau helium:

Hoʻopakele i kēlā me kēia ʻanuʻu ke hoʻopaʻa ʻia ke kanaka i loko o ka lua MRI¶

KaʻAnuʻu Hana 1: E loiloi i ke ala ea, ka hanu ʻana, a me ka paʻa ʻana i ka paʻa i ka 5 kekona mua¶

1. E hoʻokaʻawale i nā ʻeke a pau ma mua o ka hele ʻana i ka Zone IV.
2. E nānā inā hiki i ke kanaka ke paheʻe i waho me ke kinai ʻole:
3. Inā hele ka noho huila a i ʻole ke alahaka ma ka puka mua me ka pā ʻole i ka mea maʻi, a hiki iā ʻoe ke hoʻoheheʻe i ka mea maʻi i waho o ka waha hope o ka lua me ka hoʻopilikia ʻole i ka metala, ** e unuhi mua i ka mea maʻi me ke kaomi ʻole ʻana iā Quench**.
4. Ke paʻi ʻoe iā Quench, ʻo kahi noho huila kila 70-kilogram (155-paona) i hoʻopaʻa ʻia ma luna o ka lua e ka magnetism e hāʻule koke i lalo i ka mea maʻi** i ka wā e pohō ai ka māla.
5. Inā paʻa kino ke kanaka, ʻeha, a paʻa paha: Mai hoʻopau manawa i ka huki lima ʻana. Ma ka 1.5T a hiki i 3.0T, paʻa ka pahu kila me 400 a 2,500 kilokani (900 a 5,500 paona) o ka ikaika, a ʻo ka hoʻohana iki ʻana e hoʻihoʻi ʻia e like me ka pahele bea.

KaʻAnuʻu Hana 2: E kaomi i ke pihi ʻulaʻula Quench Quench a hoʻopaʻa i ka ukana no ka hāʻule ʻana o ka gravity¶

1. E wehe i ka uhi plastik akaka ma ke pihi ʻulaʻula "MAGNET STOP / QUENCH" (aia ma ka paia o ka lumi scan a ma ka Zone III) a kaomi paʻa.
2. E hoʻomaopopo i ka puka aniani hoʻopau hoʻopau 30-a-120-kekona:
3. Hoʻomaʻamaʻa ka mea hoʻomehana kūloko i ka coil niobium-titanium ma luna o 9.3 Kelvin (minu 263.8 degere Celsius) i loko o 2 a 5 kekona, e hoʻohuli ana i ka superconducting coil a hoʻolapalapa i ka wai ʻauʻau helium.
4. E lohe ʻoe i ka metala pop nui, a ukali ʻia e ka ** ʻenekini jet-engine deafening ** i ka pahū ʻana o ke kinoea helium i luna o ka paipu o ka puka makani.
5. KULA: Kākoʻo a huki hou i ka mea metala kaumaha ke hāʻule ke kahua (20 a 90 kekona ma hope o ke kaomi ʻana i ke pihi):
6. Pono nā mea hoʻopakele ʻelua i hoʻopaʻa ʻia i ka mea (a huki i hope me ke kaula nylon non-magnetic) ʻoiai ke kinai ʻana o ka magnet i ʻole e hāʻule ka umekaumaha i ke kumu kila 80-kilogram ma ke poʻo a i ʻole ka umauma o ka mea i hoʻopaʻa ʻia ke nāwaliwali ka huki ʻana.
7. Huki i ka mea i hoʻopaʻi ʻia ma luna o kahi MR-Safe stretcher i ka manawa e hoʻokuʻu ai ka lima a haʻalele koke i ka Zone IV. E mālama i ka ʻeha ʻeha, nā ʻeha o ka umauma, a me ke kahe koko ma ka Zone II; ike nā iwi haʻihaʻi a me ka ʻāʻī, ʻeha poʻo, a kahe koko.

Cryogen kinai paipu hāʻule: Ke hoʻolapalapa wai helium e kahe ana i ka scan lumi¶

No ke aha e hoʻololi ai ka paipu kīkī i haki ʻia a paʻa paha i ka Zone IV i kahi pahele overpressurized¶

I ka wā e hoʻopio ai kahi magnet MRI hoʻoluʻu ʻauʻau maʻamau, 1 lita o ka helium wai ma ka liʻiliʻi 269 degere Celsius (emi 452 degere Fahrenheit) e hoʻonui i 757 lita o ke kinoea. ʻO ka hoʻolapalapa ʻana i 1,500 lita o ka helium wai e hoʻohua ** ma luna o 1.1 miliona lita (40,000 cubic kapuaʻi) o ke kinoea** ma lalo o 90 kekona, lawa e hoʻopiha ai i ka lumi scan 8 a 10 mau manawa ma mua.

Inā paʻa ka paipu kinai o waho e ka hau a i ʻole nā pūnana manu, a i ʻole nahā ka ʻūhā wela i kahi kuʻekuʻe ma luna o ke kaupaku, ua pahū pololei kēlā cryogenic kinoea i loko o ka lumi hoʻopaʻa i hoʻopaʻa ʻia, e hana ana i ʻekolu mau mea hoʻoweliweli ola.

1. Paʻa i loko o ka puka kaomi-maikaʻi (pani ʻia nā puka e koli ana i loko):
2. Nui nā puka MRI pale RF ** e lele ana i loko o ka lumi scan **.
3. ʻOiai ʻo 0.07 a 0.14 bar (1 a 2 psi) o ke kaumaha o ka lumi e hana 1,800 a 3,600 kilokani (4,000 a 8,000 paona) o ka ikaika i ka puka 1.2-by-2.1-mika (4-by-7-kapuai), e pani ana i ka puka i wehe ʻole i ke kino.
4. Ka hana ola koke: E ho'ā koke i ka MRI Emergency Exhaust Fan. Inā pani ʻia ka puka e koli ana i loko e ke kaomi lumi i ka wā e noho ai kekahi i loko, e wawahi i ka puka aniani nānā ma waena o ka lumi hoʻomalu (Zone III) a me ka lumi nānā (Zone IV) me ka hoʻohana ʻana i kahi noho alumini a i ʻole ke kumu hoʻopau ahi keleawe. ʻO ka uhaʻi ʻana i ka puka makani e hoʻokuʻu koke i ke kaomi o ka lumi no laila e hāmama ka puka.
5. Ka noe keʻokeʻo makapō a me ka hau hau:
6. Hoʻopili ka minus-269-degree-Celsius plume i ka makū o ka lumi i loko o ka zero-visibility white fog a hiki ke hoʻoheheʻe i ka wai oxygen/nitrogen (** emi 183 a emi 196 degere Celsius**) mai ka pā hao hao.
7. E noho haʻahaʻa ma lalo o ka papa kaupaku e piʻi aʻe ana, e alakaʻi i ka mea maʻi e hoʻomoe ma ke ala o ka papahele, a e hoʻomaʻamaʻa i kekahi cryogenic frostbite ma 37 a 39 degere Celsius (98.6 a 102.2 degere Fahrenheit) ka wai; ike hypothermia and frostbite kōkua mua.
8. Ka hoʻomake ʻana o ke kinoea inert wikiwiki:
9. Ke hoʻoneʻe nei ka helium i ka oxygen ma lalo o 6 a hiki i ka 10 pakeneka, ʻike ka poʻe i ka pōloli ea ʻaʻohe carbon dioxide**; huli ko lākou leo ​​i ka leo kiʻekiʻe no ka lua ʻākau ma mua o ka ʻike ʻole ʻana ma 1 a 2 hanu; ike ʻoki ʻia ka pahu pahu pahu kinoea i hoʻopaʻa ʻia a me nā leak cryogenic. Mai komo hou i kahi lumi MRI i piha i ka noe me ka SCBA puʻe maikaʻi (a ʻaʻole hoʻi e hoʻokomo i nā pahu kila SCBA i loko o ka Zone IV a hiki i ka pau ʻana o ke kinai ʻana).

ʻO ka Radiofrequency (RF) wela wela i loko o ka lua MRI¶

Kiʻekiʻe ka ** Radiofrequency (RF) transmitter coils** (64 MHz ma 1.5T a i ʻole 128 MHz ma 3.0T) hoʻoulu i nā ʻāwī eddy uila i loko o ke kino e hoʻoulu ai i ka hohonu ** lua a i ʻole ke kolu-degere wela ma o ʻekolu mau hana:

1. ** ʻO nā puka lou i ka ʻili a me ka hoʻopili ʻana i ka paia:** Ke hele ʻana i nā kuʻekuʻe wāwae ʻole, ka puʻu ʻana i nā lima ʻole ma luna o ka ʻūhā, a i ʻole ka hoʻopā ʻana i nā ʻūhā ʻūhā e hoʻopā ai i kahi puka hoʻopaʻa paʻa kahi e kū ai ka RF i kēia manawa ma kahi o ka wahi hoʻopili ʻili liʻiliʻi, ka mea wela ma luna o 60 degere Celsius (140 degere Fahrenheit). ʻO nā kuʻekuʻe lima a i ʻole nā ​​poʻohiwi i kaomi pololei i ka paia o loko me ka ʻole o ka 1-a-2-kenimika (0.5-a-1-ʻīniha) pulupulu e ʻeha pū ana i ka wela RF hohonu.
2. Nā microfibers metala huna a me nā ʻāpana lāʻau lapaʻau transdermal: ʻO nā lole pāʻani antimicrobial a i ʻole "copper-infused" i loaʻa i ke kālā microscopic a i ʻole nā ​​kaula keleawe e wela wikiwiki. ʻO nā lāʻau lapaʻau i kākoʻo ʻia me ka metallic (fentanyl, nicotine, nitroglycerin, a i ʻole scopolamine) e puhi i ka ʻili a hoʻoulu i ka nui ka lāʻau wela nui i loko o nā capillaries ʻili.
3. E hana koke i ka wā e ʻomi ai ka mea maʻi i ka puʻupuʻu pumehana no ka mahanahana: Hoʻopau koke i ka scan ma ka hōʻike mua o ka ʻeha a i ʻole ka wela. E hoʻoneʻe i ka mea maʻi i waho, e wehe i nā ʻaʻahu mehana a i ʻole nā ​​​​pilikia, a e hoʻomaha i nā wela wela ma lalo o ka wai kahe ma Zone II no 20 mau minuke; ike ke kuni a me ka wela ke kokua mua.

Ma mua o ka hoʻokomo ʻana i ka papa inoa loiloi palekana MRI¶

Ma mua o ka hele ʻana o kekahi kanaka a mea lako paha mai ka Zone III a i ka Zone IV:

• E hoʻololi i kēlā me kēia mea maʻi i ka lole hōʻaiʻē 100% pulupulu metala ʻole: Wehe i nā lole alanui āpau, nā ʻaʻahu pāʻani antimicrobial, nā pale wīwī, nā ʻāpana lāʻau i kākoʻo ʻia metala, nā mea nani, nā lauoho, nā mākaʻikaʻi glucose, a me nā pamu insulin ma Zone II.
• E nānā i kēlā me kēia mea pane a me ka malihini ma ka waha a me ka ferromagnetic detector pillar (FMDS): E hōʻoia ʻaʻole ʻaʻohe mea hoʻoikaika puʻuwai puʻuwai, ICD, implants cochlear, clip aneurysm, nā pū huna, a i ʻole nā ​​kāmaʻa wāwae kila ma ka puka.
• Paʻa i kahi MR-Safe non-magnetic evacuation gurney ma waho koke o ka puka Zone IV: E hoʻomaʻamaʻa i ka unuhi ʻana i ka mea maʻi code simulated mai ka lua i loko o ka Zone II i ma lalo o 30 kekona.
• E kau i nā pads foam insulating (1 a 2 knm mānoanoa) ma waena o ka ʻili o ka mea maʻi a me ka paia o ka lua, nā wili RF, a me nā lālā ʻeʻe: Kāohi i nā puka lou ʻili a i ka ʻili (kuʻekuʻe wāwae a i ʻole nā ​​lima e pā i ka pūhaka) i loko o ka lua.
• Nānā i ka paipu hoʻoheheʻe ʻana o ka hale o waho a me ka lumi Oxygen Depletion Monitor (ODM) i kēlā me kēia hapalua makahiki: E hōʻoia i ka ʻike ʻole ʻia o ka pale weatherhead i ka hau a i ʻole nā ​​pūnana manu a me nā pūnana ODM o ka lumi ma lalo 19.5 pakeneka oxygen.

Nā helu ulia pōpilikia āpana a me nā protocols oihana¶

Ke kāhea aku nei i ke ahi-hoʻopakele a i ʻole ke kōkua lapaʻau i ka wā o ka MRI pinning a cryogen leak, e hāʻawi i ka mea hoʻouna i ka helu Tesla pololei a inā ua pio ka magnet:

• ** ʻAmelika Hui Pū ʻIa a me Kanada:** Kāhea iā 911 (me ka Halemai kūloko Code Blue / Engineering). Noi iā Hoʻopakele ʻOihana Keʻena Kinai Ahi a me HAZMAT no ka hoʻopaʻa ʻana a i ʻole ka hoʻokuʻu ʻana i loko. Hoʻomalu ʻia e FDA Center for Devices and Radiological Health, ka American College of Radiology (ACR) Manual on MR Safety, the Joint Commission (TJC), a me NFPA 99.
• United Kingdom: Kāhea iā 999 a i ʻole 112 (a i ʻole 2222 no nā hui hāʻule NHS kūloko). E haʻi aku i ka Luna Hoʻokele ahi a hoʻopakele ma Zone III inā ola ka magnet. Hoʻomalu ʻia e ka Medicines and Healthcare products Regulatory Agency (MHRA) a me ka Health and Safety Executive (HSE).
• Uni ʻEulopa: Kāhea iā 112. Hoʻoponopono ʻia ma lalo o EU Directive 2013/35/EU ma nā kahua electromagnetic a me IEC 60601-2-33.
• Australia a me New Zealand: E kelepona iā 000 ma Australia a i ʻole 111 ma New Zealand. Hoʻomalu ʻia e ka Royal Australian and New Zealand College of Radiologists (RANZCR) MRI Safety Guidelines a me AS/NZS IEC 60601.2.33.
• India a me Asia-Pacific: E kelepona iā 112 ma India, 119 ma Iapana a me South Korea, a i ʻole 995 ma Singapore. E mālama i nā pahu oxygen kila kila a pau ma waho o ka Zone III.

Nīnau pinepine¶

ʻO ka hoʻohuli ʻana i ka mana uila nui i loko o ka lumi MRI e hoʻopau i ke kahua magnetic?¶

ʻAʻole. He 1.5-Tesla a i ʻole 3.0-Tesla superconducting MRI magnet hoʻohana i kēia manawa i loko o kahi puka pani o ka uea niobium-titanium i hoʻomaha ʻia a hiki i ka 269 degere Celsius (emi 452 degere Fahrenheit) i ka helium wai. No ka mea, ʻaʻohe pale uila o ka uea i kēlā mehana, noho ka mākia ma 100 pakeneka ikaika 24 hola i ka lā me ka ʻole o ka uila. ʻO ke kaomi ʻana i ke pihi ʻulaʻula "Emergency Power Off" (EPO) e pani wale i ka papaʻaina maʻi kaʻa, nā kamepiula, a me nā kukui lumi; e huki mau ana ka magnet i ka pahu oxygen kila a i ʻole ka noho huila ma waena o ka lumi ma 60 kilomita i ka hola (40 mau mile i kēlā me kēia hola). ʻO ke kaomi wale ʻana i ke pihi ʻulaʻula "Magnet Quench" e hoʻopau i ke kahua magnetic ma ka hoʻolapalapa ʻana i ka helium wai ma luna o 30 a 120 kekona.

Inā loaʻa ka maʻi maʻi i ka puʻuwai i loko o ka MRI scanner, no ke aha e lawe ʻole ai ka hui code i ke kaʻa ulia a me ka defibrillator i loko o ka lumi?¶

ʻO ka lawe ʻana mai i kahi kaʻa kila, defibrillator, laryngoscope, a i ʻole ʻōmaʻomaʻo ʻōmaʻomaʻo oxygen cylinder i loko o ka lumi scan MRI (Zone IV) ke kumu e ʻoki ai ke kahua magnetic i kēlā mau mea koʻikoʻi mai nā lima o ka poʻe pane a hoʻokuʻu iā lākou i loko o ka lua, e hōʻeha i ka mea maʻi a me nā limahana. ʻO ka hoʻopau ʻana i ka magnet e hoʻopau i ka 1 a 3 mau minuke koʻikoʻi a loaʻa i ka helium asphyxiation. Akā, e waiho i ka magnet, e mālama i ke kaʻa pōʻino ma Zone II, e wehe koke i ka papa MRI, e hoʻololi i ka mea maʻi ma luna o kahi MR-Safe stretcher non-magnetic, a'ōwili iā lākou ma waho o ka Zone IV ma lalo o 30 kekona ma mua o ka paniʻana i ka puka a hoʻomaka i ka defibrillation a me ka CPR ma waho o ke kahua magnetic.

I ka manawa hea wau e kaomi pono ai i ke pihi ʻulaʻula MRI Magnet Quench, a i ka manawa hea ʻaʻole wau e paʻi?¶

E kaomi i ke pihi ʻulaʻula Magnet Quench (Emergency Magnet Rundown) WALE i ka wā i hoʻopaʻa ʻia ai ke kanaka e kahi mea ferromagnetic e kūʻē i ka magnet me ka hoʻoweliweli koke ʻana i ke ola a i ʻole ka lālā, a i ʻole ke ahi hiki ʻole ke hoʻopaʻa ʻia i loko o ka lumi scan e koi i nā mea kuni ahi e komo i nā mea kila. Mai pēhi i ke pihi Quench inā paʻa ka noho huila kaʻawale, ka pahu, a i ʻole mea hana me ka ʻeha ʻole (hiki i ka ʻenekinia MRI ke hoʻopaʻa i ka magnet me ka palekana), a mai hoʻopaʻa iā ia no ka uila uila a i ʻole ka pahu kaʻa (e hoʻohana i ke pihi Electrical Emergency Power Off).

No ke aha he mea pōʻino inā hoʻomaka ka ʻohu keʻokeʻo e ninini i loko o ka lumi MRI i ka wā e hoʻopau ai ka magnet?¶

I ka wā e kinai ai, 1,500 a 2,000 lita o ka helium wai ma ka emi 269 degere Celsius (emi 452 degere Fahrenheit) e hoʻolapalapa i loko o 1.1 miliona lita o ke kinoea. Inā naha ka paipu puka o waho o ka hale a paʻa ʻia e ka hau a i ʻole ka pūnana manu, e pahū pololei ka helium maloʻo i loko o ka lumi hoʻopaʻa paʻa, e hoʻopololei i ka makū i loko o ka noe keʻokeʻo makapō. I loko o 30 kekona, hoʻoneʻe ke kinoea hoʻonui i ka oxygen hanu (no ka ʻike ʻole ʻana i ka hanu 1 a 2 me ka pōloli ʻole o ka ea) a kūkulu i ke kaomi lumi maikaʻi e pani i nā puka i loko. Inā komo ka ʻohu keʻokeʻo i loko o ka lumi, e haʻalele koke, e hoʻā i ka peʻahi hoʻopau pilikia, a e uhaʻi i ka puka makani nānā lumi hoʻomalu inā paʻa ke kaomi i ka puka komo i loko.

No ke aha e hiki ai i ka hoʻopaʻa ʻana i kahi noho huila i hoʻopaʻa ʻia i ka wā o ka kinai ʻana ke pale i ka lua o ka ʻeha i ka mea maʻi?¶

Ke huki ʻia ke kaʻa huila kila a i ʻole ke kau ʻana i loko o ka lua MRI, paʻa pinepine ka mākia i ke kila 50-a-90-kilogram (110-a-200-paona) i hoʻopaʻa ʻia ma luna o ka piko o ke awāwa ma luna o ke poʻo a me ka umauma o ka mea maʻi. Ma hope o kou paʻi ʻana i ke pihi Magnet Quench, palaho ke kahua magnetic ma luna o 30 a 120 kekona. Inā ʻaʻohe kanaka e hoʻopaʻa a huki hope paha i ke kiʻi kila i ka wā e hāʻule ai ka huki ʻumeke ma lalo o kona kaumaha, hāʻule koke ka ʻumekaumaha i ke kumu kaumaha ma luna o ka mea maʻi ma lalo.

Pehea e loaʻa ai i nā poʻe maʻi ke ʻano wela o ka ʻili i loko o kahi MRI inā ʻaʻohe mea i loko o ka scanner e wela?¶

Hoʻouna ka MRI i nā pulses radiofrequency kiʻekiʻe (RF) e hoʻoulu ai i nā au uila i nā puka lou. Inā hele ka mea maʻi i nā kuʻekuʻe wāwae ʻaʻole, hoʻopā i nā lima ʻole i ka pūhaka, a i ʻole e kaomi pololei i ka ʻili ʻole i ka paia o ka lua me ka ʻole o ka uhi ʻana i ka huʻihuʻi, ʻo nā arcs i kēia manawa ma ka wahi hoʻopili a hoʻoulu i ke ahi wela hohonu i kekona. Hiki mai ke ahi mai nā lole ʻaleʻaleʻa i loaʻa ke kālā huna a i ʻole ke keleawe anti-odor fibers a i ʻole nā ​​lāʻau lapaʻau i kākoʻo ʻia me ke kila (e like me ka fentanyl a i ʻole ka nicotine patches). E ho'ōki koke i ka scan inā ʻomi ka mea maʻi i ka puʻupuʻu kelepona e hōʻike ana i ka wela wela a i ʻole ke kuʻi ʻana.

• Hāʻawi kēia alakaʻi i ke alakaʻi palekana pilikia a me ka pane ʻeha no ka MRI projectile pinning, magnet quench incidents, a cryogen leaks a ʻaʻole ia e pani i ka hoʻomaʻamaʻa palekana ʻo Level 1 a i ʻole Level 2 MRI a i ʻole nā ​​​​kuʻina lapaʻau. E noʻonoʻo e lawe i kahi papa hana CPR a me ke kōkua mua mai ke Keʻa ʻulaʻula, St John Ambulance, a i ʻole kahi hui hoʻomaʻamaʻa lāʻau pilikia kūloko.*

Nā alakaʻi pili¶

• ʻO ka ʻāhi pahu pahu pahu hau kōpiʻi ʻia, ka pahu rocketing, a me ka wai hau hau
• ʻO ka asphyxiation wahi paʻa: manholes, silos, a me nā pahu
• ʻO ka hypothermia a me ka hau hau ke kōkua mua
• ʻO ke kuni a me ka wela ke kōkua mua

Nā kumu a me ke alakaʻi kūhelu¶

• ʻAmelika Hui Pū ʻIa o Radiology (ACR, ʻAmelika Hui Pū ʻIa): ACR Manual on MR Safety (2024 Edition, Committee on MR Safety)
• US Food and Drug Administration (FDA Center for Devices and Radiological Health, United States): MRI Safety Posters, Projectile Prevention, and Thermal Burn Alerts
• ʻO nā lāʻau lapaʻau a me nā huahana mālama olakino Regulatory Agency (MHRA, United Kingdom): Nā alakaʻi palekana no nā lako kiʻi kiʻi magnetic resonance i ka hoʻohana lāʻau lapaʻau.
• National Fire Protection Association (NFPA, United States) a me International Electrotechnical Commission (IEC): NFPA 99 Health Care Facilities Code a me IEC 60601-2-33 Nā Koina Kūikawā no ka Palekana Kuleana a me ka Hana Pono o nā Mea Hana Hoʻonaʻauao Magnetic.
• Royal Australian a me New Zealand College of Radiologists (RANZCR, Australia a me New Zealand): MRI Safety Guidelines and Emergency Quench / Cryogen Venting Protocols