MRI: MacGyver Re-appropriation Inspiration

06/16/2016

Blog post by SimGHOSTS MEA Officer Valen Anderson, Sidra Medical and Research Center, Doha Qatar

MRI: MacGyver Re-appropriation Inspiration

One of the beauties of working as a Sim Technology Specialist is the chance to create new products, combine existing commodities, and work with the means you have to “Macgyver” a solution. Personally, I love when the opportunity arises to get innovative and creative. Most recently in our Sidra Simulation Center, we had been asked to help systems test our radiology suite and more specifically, our MRI suite for emergency scenarios. As most of us are aware, MRI’s use superconducting magnets (hence their name Magnetic Resonance Imaging). These magnets are extremely strong and therefore dangerous. Since most of our simulators contain metallic objects which pose a major MRI risk and safety hazard, we were tasked with creating an “MRI safe” manikin to be used in these scenarios. Not only did we need a metal-free manikin, but this manikin needed to be mobile, monitor-able, intubatable, and connected to fluids. There are MRI-Simulation products on the market such as KbPort’s MRISim, but these simulators are simulated MRI Machines, rather than a simulated MRI manikin. Since our radiology team was systems testing their environment, it was important for them to use their actual MRI machines.

To begin, we identified a low fidelity manikin that we hoped would contained little-or-no metal: Laerdal’s BabyAnne. We identified, using the radiology’s X-ray unit, that this manikin had only three metal screws that held the head together. We were able to easily remove these screws and hold the head together with tape. We also chose to use this manikin because we have eight of these manikins at our center, commonly used in Basic Life Support (BLS) courses. With consent from our Life Support Coordinator, we began making other alterations to BabyAnne to make an appropriate model for the MRI simulation needs.

Another obstacle was that this manikin has a small, anatomically ambiguous airway that is appropriate only for bagging, and certainly not for intubation. Therefore we removed the manikin’s original airway - the small valve inside the mouth, the connecting tube, the square foamy lung - and created a larger, intubatable, ‘trachea’ using a well-lubricated Size 9 endotracheal tube; the lungs were now a single balloon. We then created an appropriate sized “IV port” on one of the baby’s arms using an IV catheter connected to a VitalSim fluid drainage bag; participants would be able to place an IV and run fluids throughout the scenario. As for monitoring, we consulted with our Biomedical Engineers who allowed us to use their Philips ‘test module’ to simulate vitals on the monitor.

We were also challenged with the task of providing live-viewing and video-recording of the simulations. This was relatively easy to do throughout the radiology suite, but was much more complicated once the patient entered the actual MRI room. To overcome this, we setup a very small, mostly non-ferrous, webcam on the inside of the MRI room doorframe and used in-built Microsoft Lync Software to stream the audio and video to a ‘Viewing Room’ between two laptops located nearby.

However big or small, these opportunities to innovate keep our creative-sides on our toes, encourage us to continually think outside the box, and even create industry prototypes!