Policy-Procedure: Adenosine Stress

  • Policy-Procedure-Adenosine-Stress.pdf

    Policy and Procedure for Adenosine Stress MRI

 

 

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 2nd or 3rd 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