Policy-Procedure: Adenosine Stress

• Policy-Procedure-Adenosine-Stress.pdf

  Policy and Procedure for Adenosine Stress MRI

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Policy and Procedure: Adenosine Stress MRI

PURPOSE:

To establish guidelines to provide for safe and effective Adenosine stress Magnetic Resonance Imaging.

POLICY:

The test will be performed by a radiologist, cardiologist, licensed nurse and trained MRI technologist. Supervising physicians and nurse shall be ACLS certified.

SUPPLIES and EQUIPMENT:

• Medications: Adenoscan 3mg/ml
• MRI compatible infusion pump: program and prepare infusion pump according to manufacturer instructions.
• Syringes 30cc to prepare adenosine
• Two #22 angiocaths and two extension sets (can use #24 for adenosine infusion)
• Crash cart with defibrillator
• 12 lead electrocardiogram machine (Cannot be used inside of MRI scan room.)

PROCEDURE:

• Prior to appointment, the chart should be screened for any contraindications.
• The Nurse or MRI scheduler will call the patient with instructions:
• The procedure will be explained and any patient questions will be answered.
• MR screening form completed and reviewed by proper personnel.
• No Caffeine for 24 hours prior to exam.
• Prior to testing, the presence of contraindications will be determined (e.g. asthma, critical aortic stenosis, second or third degree AV Block, sick sinus syndrome or symptomatic bradycardia)
• Medications can be taken.

Prior to arrival of the patient

• Ensure crash cart is accessible.
• Prepare paperwork and place on clipboard
  • Stress test consent form
  • MRI screening form
  • Adenosine MR stress worksheet
  • Progress note (if needed)
  • Informed consent for contrast

Upon arrival of the patient

• Have the patient change into a hospital gown. Patient must read and sign all consents and MR screening forms.
• Record / review pre-stress evaluation, which includes history, allergies and medications.
• Record baseline vital signs. (blood pressure, heart rate and respiratory rate)
• Record a 12-lead electrocardiogram to assess for 2^nd or 3^rd degree AV block and to serve as a baseline.
• Two intravenous lines are established with extension sets (IV’s should be started in 2 separate extremities. A foot vein can be used in nondiabetics.
• Prep patient’s skin for cardiac monitoring and place electrodes in proper position.
• Assist patient to MR room for set-up