patient safety Flashcards
magnetic field strength above which a patient with an implanted cardiac pacemaker should NOT be allowed
5 Gauss (0.5 mT)…………………… (1 Gauss = .0001 Tesla, or 1 Tesla = 10,000 Gauss)
a physician omitted the pre-procedure time out before performing a breast biopsy. The procedure went smoothly and the pathology revealed a concordant fibroadenoma. what is the behavior and corresponding managerial strategy for this physician based on “just culture”
at-risk behavior - coach them most cultural problems in medicine involve at-risk behavior which responds well to coaching rather than punishment. Repeated sequential at-risk behaviors could trigger punitive measures
52 yo presenting for a biopsy. PMH includes well controlled HTN. What is his ASA classification?
ASA Class II = a patient with mild systemic disease
ASA classification: a moribund patient who is not expected to survive without operation
ASA Class V
ASA Class V
a moribund patient who is not expected to survive without operation
ASA Class VI
declared brain dead patient whose organs are being removed for donor purposes
declared brain dead patient whose organs are being removed for donor purposes
ASA Class VI
Risk factors that warrant renal function assessment prior to IV iodinated contrast
Age > 60, history of renal disease, HTN, diabetes, metformin use
NSF symptoms begin where:
extremities
Can a type 2 gadolinium contrast agent be used in patients with chronic renal disease?
yes
Pt with ESRD, can they get a contrast MRI?
yes - with a type 2 gadolinium contrast agent
reversal of midazolam
Flumazenil 0.2 mg IV
maximum sterile barrier technique includes:
cap, mask, gown, gloves. hand washing, drapes and cutaneous anti-sepsis
“fixation of failure” is a characteristic of:
high reliability organization
High reliability organizations have the following characteristics:
fixation of failure, avoidance of oversimplification, sensitivity to operations, respect of expertise, dedication to resilience
the only “never event” specific to radiology is:
introduction of metal objects into an MRI suite
introduction of metal objects into an MRI suite
the only “never event” specific to radiology according to the criteria set by the Agency for Healthcare Research and Quality
2 yo with shunted hydrocephalus moved from another institution for routine brain MRI with anesthesia. If no anesthesiologist is available, what is another option to image the kid?
Rapid sequence MRI, no anesthesia
most common cause of MRI induced burns
skin to skin contact. burns can be caused when the patient’s skin comes in contact with the inner bore of the MRI scanner or skin-to-skin contact (usually inner thighs)
highest magnetic field strength considered safe for the general public?
5 Gauss (0.5 mT)
hearing protection must be provided for MRI exams in which sound pressure exceeds:
99 decibels
can a patient with a fractured pace lead undergo MRI?
NO!!! it is an absolute contraindication
The National Patient Safety Goals program was established by:
The Joint Commission
Ideal way to wear a ring badge to monitor radiation exposure
dominant hand under gloves
what radiation level can ring dosimeters detect
30 mrem of gamma and 40 mrem of beta
4 main principles of the Image Gently campaign
Basically do as little as possible and it doesn’t need to be perfect. 1. reduce or “child size” the amount of radiation used. 2. scan only when necessary 3. scan only the indicated region 4. scan once.
