South Tyneside NHS Foundation Trust Information regarding children having an MRI scan (with sedation) Department: Radiology Providing a range of NHS services in Gateshead, South Tyneside and Sunderland.
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Introduction This leaflet explains about having an MRI scan and what to expect when your child comes to South Tyneside NHS Foundation Trust to have one. It explains how it is done and any risks involved. What is an MRI scan? MRI (Magnetic Resonance Imaging) is the name given to a technique which takes very detailed pictures through the body. It uses a powerful magnetic field and radio waves, together with an advanced computer system to build up a series of pictures of your child's body, each one showing a thin slice of the area being examined. Unlike an x-ray an MRI scan does not use radiation to do this. These images can show both bone and soft tissues such as muscle, nerves and blood vessels and organs such as your brain and heart. Because the MRI scanner takes very detailed pictures of the body it can often show things that aren t seen on x-ray or other tests such as ultrasound. The scanner looks like a tunnel about one and a half metres long and is open at both ends. The area of the body that is under investigation will be positioned so that it is in the centre of the tunnel. Having an MRI scan does not hurt. 3
Are there any risks with MRI? MRI is an extremely safe procedure and does not hurt. It does not involve the use of x-rays. However not everyone can have an MRI scan. The magnetic field affects some metals and can cause any metal inside the child s body to move. This could potentially cause an injury. It is very important to contact us before bringing for child for their appointment if they have, or have had, any of the following:- Pacemaker Neurostimulator Artificial heart valve Aneurysm clips (metal clips that are inserted during some operations, especially in the blood vessels in the brain) Any surgery which involved placing implants in your head or body Any surgery in the six weeks before your appointment Metal fragments in the eye (even if you think the metal has been removed). You may need to have an x-ray first to prove there are no metal bits left Metal pins and plates, artificial joints and dental work that have been in for a long period of time should not create a problem but if your child has any of these you should mention it to the radiographers when you arrive. 4
Other important information Please also contact us if the following applies to your child: Your child is claustrophobic. A small proportion of people find having a MRI scan difficult due to the confined space in the scanner. If you are worried about this aspect for your child please contact the MRI department for advice Your child has problems weight-bearing and needs a hoist to transfer Your child is unable to keep still or lie flat You need an interpreter for your child or yourself. Please tell us this when you receive your appointment so that we can arrange an official interpreter for you You require ambulance transport to bring your child to the hospital. We may need to change the time of your appointment. You will need to contact your GP to book the ambulance transport Your child has any serious allergies If your child has any other special needs that may affect your visit to us, for example visual impairment If you fail to inform us of any of the above we may be unable to scan your child on the day of your appointment. What are the alternatives to an MRI scan? Alternatives include x-rays, CT (computed tomography) scans, angiography (all of which involves exposure to radiation) and ultrasound (which uses sound waves). However if your doctor has requested an MRI scan it is usually because this will give them the clearest answer for your child. 5
Is there any preparation for the scan? Your child s appointment letter will ask you to confirm that your child can attend the appointment time that has been offered. When you telephone you will be asked some safety questions to check the scan is suitable for your child. You will also be able to ask any questions that you may have about the scan. Your child will need to be admitted onto the Childrens Day Care (Ward 12). You will need to attend the ward prior to your MRI scan appointment time. The purpose of this is to allow you and your child to prepare for the procedure. Your appointment letter will tell you what time you need to attend the ward. You will meet a childrens nurse and doctor who will assess your child and give a full explanation of what the procedure involves It is helpful if your child can wear clothes that contain no metal parts such as zips or hooks. You will also be asked to remove anything which may contain metal from your child such as, glasses, hairpins, jewellery, body piercing or money. Please remove any makeup, nail polish or other cosmetics that contain metal as they may affect the pictures. If possible please leave any valuables at home. To obtain clear pictures, the patient needs to remain still in the MRI scanner. Most babies and young children are unable to lie still and need to be sedated during the examination. What is sedation? Sedation is medication given by mouth or intravenously (an injection via a vein in the arm) so that your child goes to sleep for a scan. Children under the age of 18 months will receive sedation by mouth. There is no preparation for this. Your child can follow their normal eating and sleeping patterns. The sedation will be given by a nurse on the ward approximately an hour before the MRI scan. Children over the age of 18 months will be sedated intravenously. Your child will have an anaesthetic (numbing) cream applied to 6
their skin one hour before their injection. Your child will need to fast (no food or drink) for four hours before they are admitted to the ward. The intravenous sedation will be given by the doctor immediately before the MRI scan. In specific cases there may occasions where children between 12 and 18 months will require intravenous sedation instead of oral sedation. We will inform you if this applies to your child as they will need to fast for four hours before they are admitted to the ward. Alternatives to sedation General anaesthesia (gas) is used at some hospitals to ensure that children stay still during the MRI scan. This is not available at the MRI department at South Tyneside NHS Foundation Trust. What happens when we arrive at the MRI department? The doctor and/or nurse will accompany you and your child to the MRI department. You will then meet the MRI radiographers who will go through a questionnaire with you to ensure that it is safe for both you and your child to enter the MRI controlled area. Once this has been done you and your child will be taken into the patient preparation area. If your child is having intravenous sedation they will receive this whilst positioned on a special couch, or seated on your lap. It is perfectly normal if your child's eyes stay open when they are sedated. The doctor will remain with your child during the scan. You will be taken to the MRI waiting area. What happens during the scan? Once sedated, your child will be transferred into the scan room on a special couch. When your child is in the correct position the radiographer will move your child on the table into the scanner. The radiographer will then go into the control room and start the scan. The scanner will make a continuous knocking sound throughout the scan and a loud banging noise when a picture is being taken. Your child will be given ear protection for this noise. 7
When the scan is over your child will be transferred into the patient recovery area. If you have been waiting outside you will then be reunited with your child before they are transferred back to the ward for observation. Once the paediatric team are satisfied that your child is fully awake, you may take your child home. Most families are able to go home a couple of hours or so after the scan. How long will the scan take? The scan will normally take about 30 minutes. Please expect your child to be in the department for at least one hour as their appointment time also includes the time for us to check their safety questionnaire and prepare them for their scan. On rare occasions emergency patients must be scanned and this may lead to a delay. However, we will keep you informed of any delays. Will my child need to have an injection? Depending on the part of the body that is being examined, it is sometimes necessary to inject a contrast medium (dye) into the area, to make some of the tissues show up more clearly. This is different to the contrast / dye used for some x-ray examinations. The doctor will give this injection in a vein in your child's arm or hand. The injection should not have any effect on your child. The MRI contrast is rapidly cleared through the body by the kidneys. As it is a clear solution your child will not notice it passing. Is MRI contrast safe? As with all medication, a very small number of patients may be allergic to MRI contrast. Allergic reactions are rare and when they do occur, most of them are mild and are usually noticed during or immediately after the examination. Reactions may include headache, dizziness, and pain around the injection site, nausea / vomiting and skin reactions. 8
If your child experiences any of these effects during the 24 hours after they have left the department please contact us on 0191 404 1081. Outside normal working hours please contact the Accident and Emergency Department. Despite these slight risks, your child s doctor believes it is advisable that they have this examination and do bear in mind that there are greater risks from missing a diagnosis by your child not having their scan. Please inform the radiographer if your child has any allergies or has any kidney problems. Post discharge information for sedation The nurses will tell you what sort of sedation your child has had. The following information should help you care for your child when you first go home: Children are generally sleepier than usual for 24 hours after an MRI scan with sedation. Keep a close watch on your child until he or she is back to normal. Do not leave him or her with an inexperienced carer. If your child is on any medication, give this as normal. Your child should be well enough to go to school the day after the MRI scan. When will I get my child s scan results? The radiographer will not be able to give you your child s results on the day of their scan as the MRI images will need to be interpreted carefully by a radiologist. The results of the scan will be sent back to the person who sent your child for the scan within five working days. If you have not received an appointment to see your child s referrer within three weeks of having their scan, you will need to contact them to check when you will receive the results. 9
What if I can t keep my child s MRI appointment? If your child can t keep their appointment please contact the MRI department straight away. If your child is admitted to hospital before their appointment, please tell the ward staff that they have an MRI appointment booked. If you have a query about the MRI scan If you have any other questions, worries or doubts, do not hesitate to contact us prior to your child s appointment on: MRI Department: 0191 404 1081 Opening hours: Monday-Thursday 8.15am-7pm, Friday 8.15am-5pm, Saturday 8.45am - 12noon. Other Sources of information For general information about Radiology Departments visit the Royal College of Radiologists website: www.goingfora.com For other MRI information leaflets visit South Tyneside Foundation Trust website: www.sthct.nhs.uk/forpatients/patient-information 10
How to find us For directions and map of the hospital visit South Tyneside Foundation Trust website: www.sthct.nhs.uk/for-patients/howto-find-us The MRI Department is located off the Hospital Main Corridor; there are numerous signs to guide you. From the Ingham Wing Main Entrance - go straight on, past reception, the hospital shop and the lift lobby. Turn left onto the main corridor, turn right before you reach X-Ray the MRI Department is on your right hand side. From the Outpatients Entrance - go straight on past the Help Desk and Coffee Shop, until you come to the end of the carpeted area. Turn right onto the Main Corridor; continue on past X-Ray, the next left will bring you to the MRI Department From the Maternity Entrance - go straight on past the Delivery Suite, lift area, Chapel and Restaurant onto the main corridor, continue along this for some distance, and take the first right hand turn you come to. The MRI Department is on the right hand side. Comments and suggestions South Tyneside NHS Foundation Trust is in constant review of the service it provides. If you have any comments, suggestions or complaints concerning your visit, please raise these with a member of staff during your visit. If you wish to put these in writing please address this to the Head of Service, Radiology Department, South Tyneside NHS Foundation Trust, Tyne & Wear, NE34 0PL 11
Contact details South Tyneside NHS Foundation Trust Harton Lane South Shields Tyne and Wear NE34 0PL MRI Department: 0191 404 1081 This leaflet is intended to give a general description of an MRI scan which may help you to understand it better. It does not necessarily describe the service, problem or procedure exactly. It does not take the place of a consultation, and any questions and concerns should be addressed directly to a doctor or health advisor. We are committed to raising the standard of written information for patients, their carers, people who use the NHS and the general public. This information can be made available in another format or language on request. For further copies of this leaflet please contact on telephone number above. Production date: August 2013 Author: Lead Radiographer MRI Scanning Department Code: 0813/342 Review Date: August 2016