MRI with Anesthesia Workflow Tips

Inpatient MRI (add-on)

Provider Roles:

Ordering Provider

Anesthesia Team

MRI technologist

Place order for MRI in Epic and mark “anesthesia” for the order question “What is this patient’s sedation requirement”.

Ask OR Front Desk to make a magnet for the case

Schedule case, coordinate with D1

Call D1@ x30001: Provide patient info including MRN, indication for MRI, urgency, last PO intake, consent status

Coordinate with MRI tech re availability/timing x30011

 

Verify MRI checklist

Place NPO at midnight order for day of procedure

Verify that appointment is visible on Snapboard/Status Board (if not, ask tech to schedule it)

Assist during induction, movement of pt to MRI table, and transport

Call MRI x30011 or x30004 and ask scheduler or tech to put the appointment on the schedule (“the grid”)

Alert anesthesia tech x31022

 

Tips and Pitfalls:

  • MRI procedures are “appointments”, not cases, and as such do not have an “add-on” board-type mechanism in Epic.  They will not be visible to Anesthesia on any Status Board or Snapboard until they are scheduled.
    • If you can’t see the case (/appointment), ask the MRI tech to schedule it
    • If you still can’t find it, ask the tech to add an “anesthesia resource” as a request or make sure the ordering provider selected “anesthesia” as the sedation requirement when ordering the study
    • If all else fails and the case is emergent, find the patient via a patient list (based on their location), double-click on their name, and select “Unscheduled MRI” to document on, then link the anesthesia case to the procedure later.
    • Another way to find patients with MRI ordered with anesthesia is a patient list.  Go to Patient Lists > Zuckerberg Hospital > ZSFG Anesthesia with Radiology > AN Radiology under Anesthesia
  • If your anesthesia workspace looks incomplete and says you are in a “pre-charting” space, the patient hasn’t been “arrived” yet (yes, even if they are inpatient).  Ask the tech to “arrive” the patient and then you will have access to the full workspace

Outpatient MRI

Tips for Discharge:

The unique aspect of outpatient MRI patients is that there is no proceduralist, so the anesthesia provider (attending) is responsible for discharging the patient.

  • There are essentially two required items for discharge from the visit:
  1. Med Reconciliation
  2. Discharge Order
  • When you have the Postprocedure tab open, find "Discharge Orders" amongst the selections on the left half of the screen.  Selecting this will bring up a mini discharge navigator from which you can perform the med rec and sign a discharge order

 

Detailed MRI tips (with screenshots) PDF

Revised Jan 2023 by A Wight