Resident Resources

MRI Policy


General Comments

Children below five years of age will, in general, require sedation prior to performance of MRI. Children up to 18 months of age are often successfully sedated with chloral hydrate, however from 18 months to five years of age (and at other ages depending upon the clinical situation) referral should be considered to the sedation team, or to anesthesia. Unless specifically otherwise noted, requests for MRI with sedation (children 18 months to 5 years of age) will be scheduled with the sedation team. If not available within the requested time frame below, scheduling clinicians will be notified and have the choice of either 1) sedation as ordered by the floor (unit) team or 2) scheduling with anesthesia as described below. Most children older than 5 years of age can undergo MRI examination without sedation.

Routine MRI - inpatient

  1. Order in chart by six AM on the morning of the study
  2. Verbal notification of MRI, beginning at six AM weekdays or 7AM, weekends at 2650106. Verbal notification should be done by housestaff.
  3. Parents either available or contact number verified. Parents notified to expect call from MRI staff.
  4. Sedation orders written (as above).
  5. Sedation permits signed.
  6. Nothing by mouth after 2 AM
  7. Intravenous line in place, if necessary because of NPO status, anesthesia, or need for contrast.
  8. Concise indication on chart.

Assuming the above steps are followed, MRI will be performed on the day of request, assuming MRI notification by 8 AM. Obviously, if possible, notification on the day prior to the planned study is desirable.

Routine MRI with anesthesia - inpatient

Anesthesia performs routine MRI's on Tuesdays and Thursdays. Orders for the study must to be written (and taken off!) prior to noon on the day before the desired study. In addition, MRI should be notified by telephone at 265-0106. Such patients will be posted on the OR schedule for the following day. This schedule is first available at 2PM, on the date prior to the planned study. As a result, if the patient does not appear upon the OR schedule by late afternoon of that day, or if the patient does appear on the schedule but is listed as an outpatient rather than an inpatient, the anesthesia attending should be notified at 494-4990. Responsibility for checking the OR schedule (265-0023) will fall to the ordering physician, although same may be delegated to other members of the care team. The same is true should a preop visit not occur before 10 p.m. on the day prior to the scheduled examination. Assuming the above parameters are met, routine MRI’s will be performed on the Tuesday or Thursday following the request.

Urgent MRI with or without anesthesia - inpatient

Urgent MRI’s are those that must be performed within a specific, rapid timeframe, but generally within regular hours in MRI. Thus, an urgent MRI scheduled at 3AM could wait until 6 AM on weekdays or 7 AM on weekends. To schedule such studies, the attending physician requesting the MRI (or, preferably, the consulting attending physician requesting the study) must directly call the anesthesia attending at 494-4990 to discuss the case and request priority, if anesthesia will be required. This must be done as soon as the MRI is contemplated. In addition, MRI should be notified by calling 265-0106. This should be done as soon as the MRI is ordered, with a voicemail left for the next morning. Subsequently, at 6 AM weekdays or 7 AM weekends, the MRI technician should be called at 265-0106 to verify the study. There is no need to discuss with radiology resident on call at night. Questions regarding MRI priority from the radiology perspective can be discussed with the daytime radiology resident or the radiology attending on call.

Emergent MRI - inpatient

These studies are defined as those requiring immediate performance. Criteria for same are typically limited to, spinal cord compression, arterial dissection and dural venous thrombosis, although it is recognized that other indications may rarely necessitate an emergent study. In these cases, the requesting attending physician (or consulting physician) must call the attending anesthesiologist at 494-4990 and notify them of the study, if anesthesia will be required. In addition, the radiology resident on call must be notified. They in turn must call in the MRI technicians. The radiology resident will not have the authority to delay or refuse the examination. Should he/she choose to do so, they will defer to the radiology attending, who will discuss the case directly with the requesting attending physician.

MRI prioritization and triage

Existing MRI prioritization protocols will continue to be in effect. All other things being equal, children will be ranked in order of age, youngest first.

University of Florida and Shands Updated: Wednesday, December 20, 2006, © 2005 University of Florida