MRI Magnet Projectile Pinning, Emergency Quench Button, ndi Cryogen Vent Kulephera¶

Makanema a Clinical magnetic resonance imaging (MRI) amagwira ntchito pogwiritsa ntchito ma elekitikitimu a superconducting omwe amavotera makamaka pa 1.5 Tesla (15,000 Gauss) kapena 3.0 Tesla (30,000 Gauss), okhala ndi magulu ofufuza apadera omwe amafika ku klzzwxh:0001, ngakhale cholumikizi chojambuliracho chikazimitsidwa, pakati pa odwala, kapena pazipatala zonse zazimitsidwa zamagetsi. Ngati woyankhira, woyang'anira, kapena wachibale wosatetezedwa abweretsa silinda yachitsulo ya ferromagnetic chitsulo, ngolo yakuwonongeka kwachipatala, chikuku chopanda MR-conditional, chotchingira pansi, kapena mazenera achitsulo kudutsa pakhomo kupita ku MRI Zone IV (chipinda cha maginito)**, kutsetsereka kwa lo otsetsereka ndi kutsegulira kwa chitsulo pafupi ndi chitsulocho. isocenter wa ngalande ya maginito ngati chipolopolo cha cannon pa 45 mpaka 70 kilomita pa ola (28 mpaka 45 mailosi pa ola) ndi mazana kapena masauzande a kilogalamu kukoka mphamvu.

Munthu akakhomedwa mkati mwa MRI yonyamula pakati pa nyumba ya maginito ndi chitsulo choyala, chikuku, kapena silinda ya okosijeni, palibe opulumutsa amphamvu omwe amatha kukoka chinthu chachitsulocho ndi dzanja, ndikubweretsa zitsulo zachitsulo kapena nkhwangwa zamoto mchipindamo zimangopanga ma projectiles owopsa. Kutulutsa munthu woika pachiwopsezo mkati mwa bowo kumafuna kukanikiza kotetezedwa kofiyira Batani la Emergency Magnet Rundown (Quench), lomwe limawononga dala mphamvu ya ma coils a maginito ndipo limawira mpaka malita 1,500 mpaka 2,000 (400 mpaka 530 mpaka 530 magaloni pa 5 minus minus madigiri 2 Celsius) (2 minus minus degrees Celsius) Fahrenheit)**. Komabe, ngati chitoliro chakunja cha cryogenic quench vent chatsekedwa ndi ayezi, zisa za mbalame, kapena kulephera kwa disc, madzi otentha a helium amakula ** 757 nthawi mu voliyumu ** mwachindunji mkati mwa chipinda chotsekedwa chotsekedwa, ndikupanga chipinda chopanda mpweya, chozizira kwambiri, chomwe chimatseketsa anthu okhalamo potseka zitseko zolowera mkati. Kudziwa nthawi yoti musindikize batani lofiira la Electrical Emergency Power Off motsutsana ndi batani lofiira la Magnet Quench, momwe mungatulutsire chitoliro chophwanyidwa, ndi momwe mungatsitsimutsire wodwala kumangidwa kwa mtima mwa kuwasuntha ** kuchoka ku Zone IV kupita ku Zone III ** asanabweretse ngolo yowonongeka ndi defibrillator amapulumutsa miyoyo; sungani kwanuko manambala angozi okonzeka, ndi kubwereza wothinikizidwa gasi yamphamvu vavu kukameta ubweya ndi kutayikira cryogenic, kutsekereza danga kupuma,ndi hypothermia ndi frostbite thandizo loyamba.

Chitani izi tsopano¶

1. **MUSAMAlowe m'chipinda chojambula cha MRI (Zone IV) mutanyamula chitsulo chilichonse kapena chinthu chosadziwika chachitsulo, ngakhale panthawi ya kumangidwa kwa mtima kwa wodwala kapena moto. chotsani makiyi onse, ma pager, mafoni, lumo, stethoscopes, matanki a oxygen, ndi mapaketi a SCBA ozimitsa moto musanawoloke mzere wowopsa wapansi ku Zone IV.
2. **Ngati wodwala agwidwa ndi mtima, kumangidwa kwa kupuma, kapena anaphylaxis mkati mwa MRI scanner, OSATI kubweretsa ngolo kapena defibrillator m'chipinda chojambulira, ndipo OSATI kuzimitsa maginito. Zone IV mu Zone III kapena Zone II ** (malo odikirira / ogwirizira) mkati mwa masekondi 15 mpaka 30 kuti gulu la ma code lizitha kusokoneza ndikulowetsa motetezeka kunja kwa maginito.
3. **Dinani batani lofiira lotetezedwa la MAGNET QUENCH (Emergency Magnet Rundown) ZOKHA pazochitika ziwiri zadzidzidzi zamoyo kapena imfa: (a) munthu wapanikizidwa kapena kuphwanyidwa ndi chinthu cha ferromagnetic motsutsana ndi maginito chomwe chikhoza kuopseza moyo kapena miyendo, kapena (b) moto wosalamulirika m'chipinda chojambulira chomwe chili ndi zitsulo zozimitsa moto kuti zilowetsedwe ndi zitsulo zozimitsa moto. (monga chotchingira pansi kapena chikuku chopanda kanthu) ngati palibe munthu wovulala kapena wotsekeredwa; ogwira ntchito ya uinjiniya amatha kutsitsa maginito pansi bwino popanda kuwira pa helium.
4. NTHAWI YOMWEYO Kuzima kwa Magnet kumayambika (kaya kumangoyambika ndi batani kapena kuchitika mwadzidzidzi ndi mluzu waukulu ndi kubangula), TULUMANI munthu aliyense m’chipinda chojambulira MRI mwamsanga. Musadikire m’chipindamo kuti mphamvu ya maginito igwe ngati wovulalayo atha kumasulidwa kapena ngati chifunga choyera choyera chiyamba kukhuthukira m’chipindacho kuchokera ku nyumba ya maginito; chitoliro chong'ambika kapena chotsekedwa chozimitsira mpweya chimadzaza chipindacho ndi mpweya wa helium wofewa komanso kuthamanga kwabwino pasanathe masekondi 30.
5. **Ngati chitseko cha MRI chomwe chikugwedezeka mkati chatsekedwa kuchokera mkati ndi mpweya wabwino panthawi yozimitsa (kuwomba m'chipinda), thyola zenera loyang'anira chipinda chotchinga chamkuwa chotetezedwa ndi ma mesh nthawi yomweyo pogwiritsa ntchito chinthu cholemera chomwe sichikhala ndi maginito (monga chopondera cha aluminiyamu, chozimitsira moto cha mkuwa, kapena bolodi lapulasitiki lofanana) kuti muchepetse kupanikizika kwa chitsekocho, tsegulani zenera lotseguka. mosavuta.
6. Pamoto wamagetsi, chingwe choyatsira, kapena pinch ya injini yapatebulo pomwe palibe wopinikizidwa ndi maginito, dinani batani la Electrical EMERGENCY POWER OFF (EPO) m'malo mwa batani la Magnet Quench. Batani la EPO limapha nthawi yomweyo mphamvu zonse zamagetsi za 480-volt AC zofikira zokulirapo, radiofrequency (RF) transmitters popanda kutulutsa maginito amadzimadzi, ndi ma transmitters amphamvu a radiofrequency (RF) helium.
7. Imbani foni gulu lanu la ma code ndi nambala yanu yadzidzidzi (911 ku United States ndi Canada, 112 kudutsa European Union, 999 ku United Kingdom) ndi kuchenjeza ozimitsa moto ndi azachipatala ofika pakhomo la kunja kwa Zone III kuti maginito a MRI ali LIVE. Tumizani wogwira ntchito wodzipereka ngati chotchinga chaumunthu pakhomo la Zone IV kuti azivula zitsulo zazitsulo za Nyumba ya Oxygen ya SCBA, nkhwangwa zachitsulo za SCBA ma silinda omwe amabwera kwa anthu obwera mwadzidzidzi asanafike pakhomo.

Mtengo wosankha: MRI scan chipinda choyesera mwadzidzidzi¶

flowchart TD
    Start["Zadzidzidzi Mkati Kapena Pozungulira Malo Ojambula a MRI (Zone IV)"] --> Scenario{"Kodi ndi mavuto otani amene akuchitika panopa?"}
    Scenario -->|"Khodi Yachipatala ya Wodwala (Kugwidwa kwa Mtima, Kugwidwa, Kusiyanitsa Kwambiri)"| MedCode["1. OSATI kubweretsa ngolo yowonongeka, thanki yachitsulo O2, kapena AED ku Zone IV; 2. OSATI akanikizire maginito kuzimitsa batani; 3. Tsegulani / kumasula tebulo la odwala ndikutulutsa wodwala OUT ku Zone III/II nthawi yomweyo; 4. Yambani CPR ndi kutsitsimula kwathunthu kwa ACLS kunja kwa maginito"]
    Scenario -->|"Ferromagnetic Chinthu Chokokedwa Mu Magnet Bore"| PinCheck{"Kodi munthu wapachikidwa, kuphwanyidwa, kapena kupachikidwa?"}
    PinCheck -->|"INDE: Munthu Wopanikizidwa Ndi Chiwopsezo cha Moyo / Miyendo"| QuenchNow["1. Yendetsani chitetezo cha pulasitiki ndikusindikiza batani la RED MAGNET QUENCH nthawi yomweyo; 2. Yang'anirani chifunga choyera kapena helium yobangula mkati mwa chipinda (kulephera kwa mpweya); 3. Gwirani chinthu chachitsulo cholemera kwambiri kuti chisagwere pa odwala ngati madontho akumunda (60 mpaka 120 sec); 4. Kokani wovulalayo ndi chinthu momveka bwino ndikutuluka m'chipinda nthawi yomweyo"]
    PinCheck -->|"AYI: Zida Zokha Zomwe Zakhala (Palibe Wogwidwa)"| NoQuench["1. OSATI akanikizire maginito kuzimitsa batani; 2. OSAYESA kuthyola chinthu ndi zida zachitsulo; 3. Chotsani m'chipinda, pafupi ndi khomo, ndikuyimbirani injiniya wopanga MRI kuti muchepetse kutsika"]
    Scenario -->|"Mkokomo Waukulu / Chifunga Choyera / Kuzimitsa Modzidzimutsa kapena Cryogen Leak"| CryoLeak["1. Chotsani odwala ndi ogwira ntchito ku Zone IV MWAMODZI; 2. Yatsani chipinda cha MRI Emergency Exhaust Fan switch mu chipinda chowongolera; 3. Ngati chitseko cholowera mkati chikukakamira chifukwa cha kukanikiza kwa chipinda, phwanyani zenera kuti mutulutse mphamvu; 4. Osalowanso mchipinda chodzadza ndi chifunga chopanda SCBA (ngozi yopumira)"]
    Scenario -->|"Utsi Wamagetsi, Coil Sparking, kapena Table Mechanical Pinch"| ElecEPO["1. Dinani batani la Electrical EMERGENCY POWER OFF (EPO) (OSATI batani la Kuzimitsa); 2. Kokani chogwirizira chotulutsa tebulo lamanja ndikuchotsa wodwala ku Zone IV; 3. Gwiritsani ntchito chozimitsira moto choyera/chobiriwira MR-Safe chopanda maginito ngati pali moto wawung'ono."]

Fiziki ya superconducting maginito: Chifukwa chiyani munda suzimitsidwa¶

Malo osasunthika (\(B_0\)) motsutsana.¶

Sikena yachipatala ya 1.5-Tesla kapena 3.0-Tesla MRI imapanga mphamvu ya maginito yokhazikika (\(B_0\)) poyendetsa ma amperes mazana ambiri kudzera pa niobium-titanium (\(\text{NbTi}\)) mawaya apamwamba omira mu madzi a helium pa 4.2226 digiri Celsius /52 minus minus Fahrenheit) mkati mwa vacuum cryostat. Chifukwa niobium-titaniyamu ili ndi **ziro kukana kwamagetsi ** pa kutentha kwa helium yamadzimadzi, injiniya akalowetsamo mu koyilo panthawi yoyika, yomwe imazungulira mozungulira motsekeka kosatha popanda mphamvu yakunja. Ngakhale chipatala chikataya mphamvu zonse zazikulu zothandizira ndi ma jenereta osunga zobwezeretsera, maginito amakhalabe ndi mphamvu zonse za 1.5T kapena 3.0T.

Mphamvu ziwiri zamaginito zimagwira ntchito nthawi imodzi pa chinthu chilichonse cha ferromagnetic (chitsulo, chitsulo cha carbon, faifi tambala, cobalt, ndi chitsulo chosapanga dzimbiri cha martensitic) kulowa mu Zone IV:

1. Makokedwe ozungulira (molingana ndi \(B_0\)): Mpenderoyo imakhotetsa mbali yayitali ya chinthu chachitsulo mwamphamvu kuti igwirizane ndi mizere yotuluka kuchokera kumpoto ndi kum'mwera ya bore. Masikelo achitsulo, ma wrenchi, kapena masilinda a okosijeni amapindika mpaka 40 kulemera kwa chinthucho, ndikuphwanya chogwira musanachikoke.
2. Mphamvu yochititsa chidwi yomasulira (mphamvu ya missile ya projectile, yolingana ndi \(B_0 \times \frac{dB}{dx}\)): Chimene chimakoka chinthu chachitsulo kupyola mumlengalenga ngati mizinga ndi spatial magnetic field gradient (\(\frac{dB}{dx}\)), mlingo umene munda umalimba kwambiri kuposa centimita iliyonse kufupi ndi centimita imodzi.
3. Chifukwa makina ojambulira amakono a MRI ** amatetezedwa mwamphamvu** ndi zotchingira zolimbana ndi mabala kuti makhosedwe azipatala azikhala otetezeka, mutha kuyimirira pakhomo la Zone IV mamita 3 (mamita 10) kuchokera pa sikaniyo mutanyamula thanki yachitsulo ndikumva kokoka ziro. Pa 2 mita (mamita 6.5), mumangomva kukokera kofatsa kwa kilogalamu imodzi (2.2-pounds).
4. Komabe, chitetezo chogwira ntchito chimakakamiza kusintha kwamunda wonse kupita ku 1.0 mpaka 1.5 mita (3.3 mpaka 5 mapazi)* kunja kwa bowo. Kungotenga ** sitepe imodzi yowonjezera kutsogolo (masentimita 30 mpaka 50 / mainchesi 12 mpaka 20)** kuwoloka "thanthwe la gradient." Pasanathe theka la sekondi, mphamvu yokoka imalumphira kuchokera ku 2 kilogalamu kufika ** 100 mpaka 500 kilogalamu (220 mpaka 1,100 mapaundi) **, ndikung'amba chinthucho m'manja mwako ** 10 mpaka 30 G ** ndikuchiwombera mu bore pa ** makilomita 60 pa ola (makilomita 40 pa ola) **.

Kinetic mphamvu ndi pinning mphamvu mkati mwa 1.5T ndi 3.0T bore¶

Malo anayi otetezedwa a ACR MRI ndikuyendetsa nambala yachipatala kunja kwa Zone IV¶

Buku la American College of Radiology (ACR) pa MR Safety (ndi malangizo ofanana a MHRA ndi RNZCR) amagawaniza malo aliwonse a MRI m'madera anayi:

• Zone I: Zipatala zapagulu kunja kwa chipinda cha MRI.
• Zone II: Malo olandirira alendo, zipinda zovekera, malo owonera, ndi malo osungira odwala. Zone II ndipamene magalimoto odukaduka komanso obwera kuchipatala amafika.
• Zone III: Malo otsekeredwa bwino okhoma kunja kwachipinda chamagetsi. Oyang'anira okha ndi odwala omwe amayang'aniridwa angalowe mu Zone III.
• Zone IV: Chipinda chotetezedwa cha MRI maginito chipinda, cholembedwa ndi chowunikira "MAGNET ONSE ONSE" chizindikiro ndi mzere wofiira wa ngozi.

Ndondomeko ya pang'onopang'ono pamene wodwala alemba mkati mwa bore¶

Wodwala mkati mwa ngalande ya MRI akagwidwa ndi kumangidwa kwa mtima, kusiyanitsa anaphylaxis, kapena kugwidwa, magulu a code osatetezedwa sayenera kuthamangira ku Zone IV ndi ngolo yachitsulo, defibrillator, kapena silinda ya oxygen yachitsulo:

1. MUSAZIMITSE maginito a code yachipatala, ndipo MUSAMAbweretse zida zotsitsimutsa ku Zone IV: Kuzimitsa kumatenga 60 mpaka masekondi 180 ndikuyika pachiwopsezo cha helium asphyxiation, kuwononga mphindi zovuta pakumangidwa kwa mtima.
2. Gusani batani la "Home / Rapid Eject" kapena kukoka chogwirizira chotulutsa pamakina:
3. Gome lililonse la MRI lili ndi ** makina opangira mawotchi kapena chogwirira ** chomwe chimamasula tebulo pansi pa ** 2 masekondi ** ngakhale opanda mphamvu.
4. Tsegulani wodwalayo pa MR-Safe non-ferromagnetic aluminium/pulasitiki machira osungidwa kunja kwa Zone IV.
5. Pereka wodwalayo ku Zone III kapena Zone II ndikutseka chitseko chachipinda chamagetsi cha Zone IV:
6. Kuchotsa wodwala pa bore kupita ku Zone II kumatenga **pansi pa masekondi 20 mpaka 30 **.
7. Pangani kukakamiza kwachifuwa pamanja pamanja pa MR-Safe stretcher pamene mukuyenda; onani CPR.
8. ** Tsekani ndi kutseka chitseko cha Zone IV nthawi yomweyo ** kotero kuti madotolo ndi azachipatala omwe akufika akufika sangakuthamangireni kuchipinda chamagetsi.
9. Chitani Advanced Advanced Cardiac Life Support (ACLS) mu Zone II: Mukakhala kunja kwa mzere wa 5-Gauss ndi chitseko cha maginito chotsekedwa, ikani bwinobwino defibrillator pads, laryngoscopes, ndi masilinda a oxygen.

Mabatani awiri osiyana ofiira: Electrical Emergency Power Off (EPO) vs. Magnet Quench¶

Gulu lililonse la MRI lili ndi ** mabatani awiri ofiira ofiira ** pakhoma. Kuwasokoneza mwina kumalephera kumasula munthu wokhomedwa kapena kutuluka mopanda chifukwa chosamba pa helium:

Kupulumutsa pang'onopang'ono munthu akakhomedwa mkati mwa MRI¶

Khwerero 1: Yang'anani kukhazikika kwa njira ya mpweya, kupuma, ndi kupindika mumasekondi asanu oyambirira¶

1. Chotsani m'matumba onse musanalowe mu Zone IV.
2. Onani ngati munthuyo atha kutsetsereka POPANDA kuzimitsa:
3. Ngati njinga ya olumala kapena milatho yotchinga kutsogolo kwake osakhudza wodwalayo, ndipo mutha kutulutsa wodwalayo kunja **kumbuyo kwa bowo ** popanda kusokoneza chitsulo, mutulutseni wodwalayo kaye popanda kukanikiza Kuzimitsa.
4. Mukakanikiza Quench, njinga ya olumala yolemera makilogalamu 70 (mapaundi 155) itaimitsidwa pamwamba pa bore ndi maginito idzagwa mwadzidzidzi kugwa molunjika pa wodwalayo pamene munda ukuwola.
5. Ngati munthuyo ALI wopanikizidwa, wophwanyidwa, kapena watsekeredwa: Osataya nthawi kukoka ndi dzanja. Pa 1.5T mpaka 3.0T, gurney wachitsulo amakhala ndi 400 mpaka 2,500 kilogalamu (900 mpaka 5,500 mapaundi) yamphamvu, ndipo kuigwedeza pang'ono kumapangitsa kuti ibwerere ngati msampha wa chimbalangondo.

Khwerero 2: Dinani batani lotetezedwa la Magnet Quench ndikumangirira katunduyo kuti agwetse mphamvu yokoka¶

1. ** Tsegulani chivundikiro chapulasitiki chomveka bwino pa batani lofiira la "MAGNET STOP / QUENCH"** (lomwe lili pakhoma lachipinda chojambulira komanso ku Zone III) ndikulisindikiza mwamphamvu.
2. Kumvetsetsa zenera lozimitsa la masekondi 30 mpaka 120:
3. Chotenthetsera chamkati chimatenthetsa koyilo ya niobium-titaniyamu pamwamba pa 9.3 Kelvin (osachepera 263.8 digiri Celsius) mkati mwa 2 mpaka 5 masekondi, kutembenuza koyilo ya superconducting kuti isagwirizane ndi kuwiritsa bafa lamadzi la helium.
4. Mudzamva **phokoso lalikulu lachitsulo **, kutsatiridwa ndi **mkokomo wogonthetsa m'makutu wa jet-injini ** pamene mpweya wa helium ukuphulitsa chitoliro chozimitsa padenga.
5. ZOYENERA KUCHITA: Thandizani ndikubweza chinthu chachitsulo cholemera pamene munda ukugwa (masekondi 20 mpaka 90 mutakanikiza batani):
6. Opulumutsa awiri owonetseredwa ayenera kugwira pa chinthucho (kapena kukoka chammbuyo ndi lamba wa nayiloni wopanda maginito) pomwe maginito amazimitsa kuti mphamvu yokoka isagwetse chimango chachitsulo cha 80 kilogalamu pamutu kapena pachifuwa cha wozunzidwayo pamene kukoka kwa maginito kufooka.
7. Kokerani wovulalayo pa MR-Safe stretcher pamene chogwiracho chikutuluka ndikutuluka mu Zone IV nthawi yomweyo. Chitani kuvulala kwapakhosi, kuvulala pachifuwa, ndi kutuluka magazi mu Zone II; onani mafupa osweka ndi sprains, kuvulala pamutu,ndi kutuluka magazi.

Cryogen kuzimitsa mapaipi kulephera: Pamene otentha madzi helium kusefukira chipinda sikani¶

Chifukwa chiyani chitoliro chophulika kapena chotsekedwa chozimitsa chimatembenuza Zone IV kukhala msampha woponderezedwa kwambiri¶

Maginito wamba wa MRI woziziritsidwa akazimitsidwa, 1 lita imodzi yamadzimadzi a helium pa minus 269 digiri Celsius (osachepera 452 degrees Fahrenheit) amakula kukhala malita 757 a gasi. Kuwiritsa malita 1,500 a helium yamadzimadzi kumapanga malita opitilira 1.1 miliyoni (40,000 cubic feet) a gasi mkati mwa masekondi 90, wokwanira kudzaza chipinda chojambulira 8 mpaka 10 kupitilira.

Ngati chitoliro chozimitsa denga lakunja chatsekedwa ndi ayezi kapena zisa za mbalame, kapena ngati kutentha kwatentha kuphulika chigongono pamwamba pa denga, mpweya wa cryogenic umaphulika molunjika mchipinda chosindikizidwa, ndikupanga ziwopsezo zitatu panthawi imodzi:

1. Kukhoma kwa zitseko zowoneka bwino (zitseko zopindika mkati zatsekeredwa):
2. Zitseko zambiri za MRI zotetezedwa ndi RF ** kugwedezeka mkati mwachipinda chojambulira **.
3. Ngakhale 0.07 mpaka 0.14 bar (1 mpaka 2 psi) ya kupsyinjika kwachipinda kumakhala 1,800 mpaka 3,600 kilograms (4,000 mpaka 8,000 mapaundi) yamphamvu** motsutsana ndi 1.2-by-2.1-mita (4-by-7-foot) chitseko chotsegula, kutseka chitseko chotseka.
4. Kupulumuka nthawi yomweyo: Yambitsani MRI Emergency Exhaust Fan nthawi yomweyo. Ngati chitseko cholowera mkati chatsekedwa ndi kupanikizika kwa chipinda pamene wina ali mkati, phwanyani zenera loyang'ana magalasi pakati pa chipinda chowongolera (Zone III) ndi chipinda chojambulira (Zone IV) pogwiritsa ntchito chopondapo cha aluminiyamu kapena chozimitsira moto chamkuwa. Kuthyola zenera nthawi yomweyo kumatulutsa kuthamanga kwachipinda kuti chitseko chitseguke.
5. Chifunga choyera chochititsa khungu ndi cryogenic frostbite:
6. Minus-269-degree-Celsius plume imapangitsa chinyezi chachipinda kukhala **chifunga choyera chosawoneka ziro ** ndipo chimatha kudontheza madzi okosijeni/nayitrogeni (minus 183 mpaka 196 digiri Celsius) kuchokera pa turret yachitsulo yopanda kanthu.
7. Khalani otsika pansi pa denga lokwera, wongolerani machira a wodwala pomvera pansi, ndipo tenthetsani chisanu chilichonse mu 37 mpaka 39 digiri Celsius (98.6 mpaka 102.2 madigiri Fahrenheit) madzi; onani hypothermia ndi frostbite thandizo loyamba.
8. Kupuma mwachangu kwa gasi:
9. Pamene helium imachotsa mpweya pansi pa **6 mpaka 10 peresenti **, ozunzidwa amamva **ziro carbon dioxide mpweya njala **; mawu awo amatembenukira mokweza kwachiwiri pomwe chikomokere chisanachitike mu **1 mpaka 2 kupuma **; onani wothinikizidwa gasi yamphamvu vavu kukameta ubweya ndi kutayikira cryogenic. Osalowanso m'chipinda chodzaza chifunga cha MRI chopanda mphamvu ya SCBA (ndipo musamavale matanki achitsulo a SCBA mu Zone IV mpaka kuzimitsa kutatha).

Kuwotcha kwa radiofrequency (RF) mkati mwa bore la MRI¶

High-power Radiofrequency (RF) transmitter coils (64 MHz pa 1.5T kapena 128 MHz pa 3.0T) imapangitsa mafunde amagetsi m'thupi omwe amayaka kwambiri **yachiwiri kapena yachitatu digiri ** kudzera munjira zitatu:

1. Malupu oyenda pakhungu ndi khungu komanso kukhudzana ndi khoma: Kuwoloka akakolo osavala, kugunditsa manja opanda kanthu pamwamba pa chiuno, kapena kusiya ntchafu zopanda kanthu kukhudza kumapangitsa kuti pakhale njira yotsekeka pomwe RF imagwira pakhungu, minyewa yotentha yopitilira 60 digiri Celsius (140 degrees Fahrenheit). Zigongono zopanda kanthu kapena mapewa opanikizidwa molunjika kukhoma lamkati popanda ** 1-to-2-centimeter (0.5-to-1-inch) foam pad ** amawotcha kwambiri RF.
2. Zingwe zobisika zachitsulo ndi zigamba za transdermal drug: Antimicrobial kapena "zolowetsedwa mkuwa" zovala zothamanga zimakhala ndi siliva kapena ulusi wamkuwa womwe umatentha kwambiri. Zigamba za mankhwala opangidwa ndi zitsulo (fentanyl, nicotine, nitroglycerin, kapena scopolamine) zimawotcha khungu ndi kuyambitsa kuchuluka kwamankhwala osokoneza bongo m'mitsempha yapakhungu yotambasuka.
3. Chitanipo mwamsanga wodwala akafinya nyali ya alamu kuti itenthedwe: Imitsani sikani nthawi yomweyo pa lipoti loyamba la kuluma kapena kutentha. Tulutsani wodwalayo kunja, chotsani zovala zotentha kapena zigamba, ndipo muziziziritsa kutentha kulikonse pansi pa madzi oyenda mu Zone II kwa mphindi 20; onani kuyaka ndi scalds thandizo loyamba.

Chisamaliro cha MRI chisanalowe m'ndandanda wa kafukufuku wachitetezo¶

Munthu aliyense kapena zida zisanadutse kuchokera ku Zone III kupita ku Zone IV:

• Sinthani wodwala aliyense kuvala chovala chachipatala cha 100% cha thonje chopanda zitsulo: Chotsani zovala zonse za mumsewu, zobvala zolimbana ndi tizilombo toyambitsa matenda, ma bras apansi pa waya, zomangira zachitsulo, zodzikongoletsera, zotchingira tsitsi, zowunikira shuga, ndi mapampu a insulin ku Zone II.
• Yang'anani aliyense woyankha ndi mlendo pomulankhula komanso ndi nsanamira ya ferromagnetic detector (FMDS): Tsimikizirani kuti palibe zopangira mtima pacemaker, ma ICD, ma implants a cochlear, clips aneurysm, mfuti zobisika, kapena nsapato zachala zachitsulo zodutsa pakhomo.
• Ikani galimoto ya MR-Safe non-magnetic evacuation gurney nthawi yomweyo kunja kwa khomo la Zone IV: Yesetsani kutulutsa wodwala code kuchokera pachibowo kupita ku Zone II mu pansi pa masekondi 30.
• Ikani zotchingira thovu zotchingira (zochindikala 1 mpaka 2 cm) pakati pa khungu la wodwalayo ndi khoma lobowola, zotchingira za RF, ndi miyendo yopanda kanthu: Pewani malupu akhungu ndi khungu (zopingasa kapena manja kukhudza m'chiuno) mkati mwa bowo.
• Yang'anirani chitoliro chakunja chozimitsira padenga ndi chipinda cha Oxygen Depletion Monitor (ODM) theka-pachaka: Tsimikizirani kuti chotchinga chapadenga chilibe madzi oundana kapena zisa za mbalame ndi ma alarm a ODM m'chipinda pansipa 19.5 peresenti okosijeni.

Nambala zangozi zachigawo ndi ndondomeko za bungwe¶

Mukamayitanitsa anthu opulumutsira moto wakunja kapena thandizo lachipatala panthawi ya MRI pinning kapena cryogen kutayikira, perekani wotumizayo mlingo weniweni wa Tesla komanso ngati maginito azimitsidwa:

• United States ndi Canada: Imbani 911 (kuphatikiza chipatala chamkati Code Blue / Engineering). Pemphani ** Kupulumutsidwa kwaukadaulo waDipatimenti ya Moto ndi HAZMAT ** pakupondereza kapena kuzimitsa kutulutsa kwamkati. Molamulidwa ndi FDA Center for Devices and Radiological Health, the American College of Radiology (ACR) Manual on MR Safety, Joint Commission (TJC), ndi NFPA 99.
• United Kingdom: Imbani 999 kapena 112 (kapena 2222 yamagulu angozi a NHS). Dziwitsani Mtsogoleri wa Zochitika za Moto ndi Kupulumutsa ku Zone III ngati maginito ali moyo. Imayendetsedwa ndi Medicines and Healthcare products Regulatory Agency (MHRA) ndi Health and Safety Executive (HSE).
• European Union: Imbani 112. Imayendetsedwa ndi EU Directive 2013/35/EU pamagetsi amagetsi ndi IEC 60601-2-33.
• ** Australia ndi New Zealand: ** Imbani ** 000 ** ku Australia kapena ** 111 ** ku New Zealand. Imayendetsedwa ndi **Royal Australian ndi New Zealand College of Radiologists (RANZCR) MRI Safety Guidelines ** ndi **AS/NZS IEC 60601.2.33 **.
• India ndi Asia-Pacific: Imbani 112 ku India, 119 ku Japan ndi South Korea, kapena 995 ku Singapore. Sungani ma ambulansi onse amtundu wa zitsulo za oxygen kunja kwa Zone III.

Mafunso omwe amafunsidwa pafupipafupi¶

Kodi kuzimitsa switch yamagetsi yayikulu muchipinda cha MRI kumatseka mphamvu ya maginito?¶

No. Maginito a 1.5-Tesla kapena 3.0-Tesla superconducting MRI maginito amagwiritsa ntchito kuzungulira kwa waya wa niobium-titanium woziziritsidwa mpaka kuchepera madigiri 269 Celsius (kuchotsa madigiri 452 Fahrenheit) mu helium yamadzimadzi. Chifukwa mawaya alibe mphamvu yamagetsi yaziro pa kutentha kumeneko, mphamvu ya maginito imakhala pa mphamvu ya 100 peresenti maola 24 patsiku popanda magetsi a khoma. Kukanikiza batani lofiira la "Emergency Power Off" (EPO) kumangotseka tebulo la odwala, makompyuta, ndi magetsi akuchipinda; maginito amakokabe tanki yachitsulo ya okosijeni kapena njinga ya olumala kudutsa chipindacho pamtunda wa makilomita 60 pa ola (makilomita 40 pa ola). Kungokanikiza batani lofiira la "Magnet Quench" lomwe limatetezedwa kumathetsa mphamvu ya maginito powotcha helium yamadzimadzi kupitirira masekondi 30 mpaka 120.

Ngati wodwala ali ndi vuto la mtima mkati mwa MRI scanner, bwanji gulu la ma code sayenera kubweretsa galimoto yowonongeka ndi defibrillator m'chipindamo?¶

Kubweretsa ngolo yachitsulo, defibrillator, laryngoscope, kapena silinda yachitsulo yobiriwira ya okosijeni mu chipinda cha MRI scan (Zone IV) imapangitsa mphamvu ya maginito kung'amba zinthu zolemetsa kuchokera m'manja mwa oyankha ndikuzilowetsa mu bore, kuphwanya wodwala ndi ogwira ntchito. Kuzimitsa zinyalala za maginito 1 mpaka 3 mphindi zovuta ndikuyika pachiwopsezo cha helium asphyxiation. M'malo mwake, siyani maginito, sungani ngolo yakuwonongeka ku Zone II, tsegulani tebulo la MRI mwamsanga, tumizani wodwalayo kumtunda wopanda maginito wa MR-Safe, ndi kuwatulutsa mu Zone IV pansi pa masekondi a 30 musanayambe kutseka chitseko ndikuyamba defibrillation ndi CPR kunja kwa magnetic field.

Ndi liti pamene ndiyenera kukanikiza batani lofiira la MRI Magnet Quench, ndipo sindiyenera kukanikiza liti?¶

Dinani batani lotetezedwa la Magnet Quench (Emergency Magnet Rundown) POKHALA munthu atapanikizidwa, kuphwanyidwa, kapena kupachikidwa ndi chinthu cha ferromagnetic motsutsana ndi maginito omwe angawononge moyo kapena miyendo, kapena moto wosalamulirika mchipinda chojambulira umafuna ozimitsa moto ovala zida zachitsulo kuti alowe. Osasindikiza batani la Kuzimitsa ngati chikuku chopanda kanthu, chotchinga, kapena chida chikakamira popanda aliyense wovulala (katswiri wa MRI atha kutsitsa maginito mosatekeseka), ndipo osayikanikizanso kuti pakhale kuphulika kwamagetsi kapena kupanikizana kwapatebulo (gwiritsani ntchito batani la Electrical Emergency Power Off m'malo mwake).

Nchifukwa chiyani zimakhala zowopsa ngati chifunga choyera chikuyamba kutsanulira mu chipinda cha MRI panthawi ya kuzimitsa maginito?¶

Panthawi yozimitsa, malita 1,500 mpaka 2,000 a helium yamadzimadzi pa kutentha kwa madigiri 269 Celsius (osachepera 452 digiri Fahrenheit) amawira mu mafuta opitirira malita 1.1 miliyoni. Ngati chitoliro chakunja chapadenga chaphulika kapena kutsekedwa ndi ayezi kapena chisa cha mbalame, kuzizira kwa helium kumaphulika molunjika mu chipinda chosindikizira chosindikizidwa, zomwe zimapangitsa chinyezi kukhala chifunga choyera. Mkati mwa masekondi 30, mpweya wowonjezereka umatulutsa mpweya wopuma (kuchititsa munthu kukomoka pakapuma kamodzi kapena kaŵiri popanda njala ya mpweya) ndipo kumapangitsa kuti zitseko zolowera mkati zizitsekeka. Ngati chifunga choyera chalowa m'chipindamo, tulukani nthawi yomweyo, yatsani fan yotulutsa mwadzidzidzi, ndikuphwanya zenera loyang'anira chipindacho ngati chitseko cholowera mkati chatsekedwa.

N'chifukwa chiyani kugwiritsira ntchito njinga ya olumala kapena gurney pamene mukuzimitsa kungalepheretse wodwalayo kuvulala kachiwiri?¶

Pamene chikuku chachitsulo kapena machira chikokedwa m'bowo la MRI, mphamvu ya maginito nthawi zambiri imakhala ndi chitsulo cholemera makilogalamu 50 mpaka 90 (110-to-200-pounds) chomwe chili chopendekera pamwamba pa ngalandeyo pamwamba pa mutu ndi pachifuwa cha wodwalayo. Mukakanikiza batani la Magnet Quench, mphamvu ya maginito imawola kupitilira masekondi 30 mpaka 120. Ngati palibe amene akukakamira kapena kukokera kumbuyo chitsulocho pamene mphamvu ya maginito itsika pansi pa kulemera kwake, mphamvu yokoka imagwetsera wodwalayo pansi pake.

Kodi odwala amawotcha bwanji khungu mkati mwa MRI pomwe palibe chilichonse mkati mwa scanner chomwe chimatentha?¶

MRI imatumiza ma radiofrequency apamwamba kwambiri (RF) omwe amapangitsa kuti mafunde amagetsi aziyenda mozungulira. Ngati wodwala akuwoloka akakolo opanda kanthu, kukhudza manja opanda kanthu m'chiuno, kapena kukanikizira khungu lopanda kanthu molunjika pakhoma lopanda thovu, ma arcs apano pamalo olumikizirana ndikuyambitsa kuyaka kwakuya mumasekondi. Kuwotcha kumachitikanso kuchokera ku zovala zamasewera zomwe zimakhala ndi siliva wobisika kapena ulusi wamkuwa woletsa kununkhira kapena zigamba zachitsulo (monga fentanyl kapena chikonga). Imitsani sikani nthawi yomweyo ngati wodwala afinya babu yoyimbira akuwonetsa kutentha kwapakati kapena kuluma.

*Bukhuli limapereka chitsogozo chachitetezo chadzidzidzi ndi kuvulala kwapang'onopang'ono kwa MRI projectile pinning, zochitika zozimitsa maginito, ndi kutuluka kwa cryogen ndipo sizilowa m'malo ovomerezeka a Level 1 kapena Level 2 MRI yophunzitsira chitetezo kapena ndondomeko zachipatala. Ganizirani kutenga manja pa CPR ndi maphunziro a thandizo loyamba kuchokera ku Red Cross, St John Ambulance, kapena bungwe lophunzitsira zachipatala ladzidzidzi.

Maupangiri ogwirizana¶

• Kumeta ubweya wa silinda wa gasi, kugwedeza kwa thanki, ndi kutuluka kwa nayitrogeni wamadzimadzi
• Kupumira kwa malo otsekeka: maenje, ma silo, ndi akasinja
• Hypothermia ndi frostbite thandizo loyamba
• Kuwotcha ndi scalds thandizo loyamba

Magwero ndi malangizo ovomerezeka¶

• American College of Radiology (ACR, United States): Buku la ACR pa 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, ndi Thermal Burn Alerts
• Medicines and Healthcare Products Regulatory Agency (MHRA, United Kingdom): Malangizo a Chitetezo pa Zida Zojambula za Magnetic Resonance mu Ntchito Yachipatala
• National Fire Protection Association (NFPA, United States) ndi International Electrotechnical Commission (IEC): NFPA 99 Health Care Facilities Code ndi IEC 60601-2-33 Zofunika Zapadera Pachitetezo Chachiyambi ndi Ntchito Yofunikira ya Magnetic Resonance Equipment
• Royal Australian ndi New Zealand College of Radiologists (RANZCR, Australia ndi New Zealand): Malangizo a Chitetezo cha MRI ndi Emergency Quench / Cryogen Venting Protocols