Policy and Procedure for Adenosine Stress MRI
Policy and Procedure: Adenosine Stress MRI
To establish guidelines to provide for safe and effective Adenosine stress Magnetic Resonance Imaging.
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.)
- 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