Bariatric MRI Policy

The purpose of this policy is to ensure the safe transport of bariatric inpatients from Parnassus to Mission Bay for MRI. The Mission Bay campus has MRI systems with slightly larger bore diameters that can potentially accommodate larger patients. In circumstances where an inpatient cannot be scanned on a Parnassus MRI system due to bore restrictions, transport of that patient to Mission Bay for an MRI scan will be arranged provided:

1) Radiology staff have determined that an MRI on Parnassus scanners is not feasible. Note that the patients widest circumference must not exceed 65 cm to assure that they will fit in the Mission Bay MRI.

2) No alternative imaging modality can address the clinical question. Vetting, scheduling, transporting and performing these patients is time-consuming. All the effort should be reserved only for those patients who have a strong indication for MRI. The patient’s attending will consult with the attending radiologist regarding the necessity for the patient to have an MRI. An attending radiologist must approve all cases to verify medical necessity.

If these conditions are met, then the transport process will proceed as follows:

1) The Parnassus MRI technologist will complete the MRI Bariatric Patient Transport Checklist (Appendix A below). This form is to be completed by MRI staff in collaboration with the patient’s nurse prior to transport. If there are any affirmative answers noted on the checklist, a hard stop is placed on the transport, and the exam is postponed or canceled. If the bariatric patient is not ambulatory, the patient is to be transported by gurney, with a Hoover Matt placed under the patient prior to transport. To ensure that the patient is properly screened, the MRI screening form must also be completed and reviewed by the Parnassus MRI technologist in advance of the transfer.

2) Scheduling and Coordination of MRI scan at Mission Bay. Generate an inpatient order in Radiant for the MRI exam. Contact the radiologist front desk at Parnassus, 415-353-1968, to reassign the inpatient order to Mission Bay. Contact the Mission Bay MRI supervisor at pager 415-443-5415 (MB Radiology front desk 476-5168) to arrange for scheduling of the MRI exam. Allow for a scheduling window of at least 1 to 2 days.

3) Transport of patient to Mission Bay. Patients will be transported in accordance to the guidelines outlined in the policy, “Transport and Care of Adult Patients for Off Unit Procedures.” The unit nurse will arrange for ambulance transport for arrival at the MRI suite at least 30 minutes prior to scheduled exam time.

4) The patient will remain under the care of the referring physician during the transport and standard of care will be maintained. If the patient is in a critical care unit, the patient must be accompanied during transport by appropriate medical personnel including physicians and nurses.

MRI Bariatric Patient Transport Checklist:  Appendix A (doc)