Nsf/Nfd (Nephrogenic Systemic Fibrosis or Term Paper

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NSF occurs only in patients with advanced kidney disease. Even though the cause-and-effect link is not proven, the association of NSF with gadolinium exposure is strong enough for the FDA to issue a warning. If an MR study with contrast is absolutely required, a nongadodiamide contrast using the lowest possible dose is preferable." It would also seem prudent to perform hemodialysis to enhance gadolinium elimination and to identify other potential cofactors (Busko, M.2007).

There are many issues that impact MR safety that should be considered during site planning for a given MR installation. These have historically not been dealt with in the prior versions of the ACR MR Safe Practice Guidelines. For the first time, we include in this article, as separate appendices, sections that address such issues as well, including cryogen emergency vent locations and pathways, 5-gauss lines, siting considerations, patient access pathways, etc. Yet despite their appearance herein, these issues, and many others, should be reviewed with those experienced in MR site planning and familiar with the patient safety and patient flow considerations prior to committing to construction of a specific site design. In this regard, enlisting the assistance of an architectural firm experienced in this area, and doing so early in the design stages of the planning process, may prove most valuable (Kanal, E., 2007).

From there, in order to decrease the health risk, there are some safety procedures that they need to take care of (Kanal, E., 2007).

All clinical and research MR sites should maintain MR safety policies (Kanal, E., 2007)

These policies and procedures should also be reviewed concurrently with the introduction of any significant changes in safety parameters of the MR environment of the site (e.g., adding faster or stronger gradient capabilities or higher RF duty cycle studies) and updated as needed.

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In this review process, national and international standards and recommendations should be taken into consideration prior to establishing local guidelines, policies, and procedures (Kanal, E., 2007)

Each site will name an MR medical director whose responsibilities will include ensuring that MR safe practice guidelines are established and maintained as current and appropriate for the site. It is the responsibility of the site's administration to ensure that the policies and procedures that result from these MR safe practice guidelines are implemented and adhered to at all times by all of the site's personnel (Kanal, E., 2007)

Procedures should be in place to ensure that any and all adverse events, MR safety incidents, or "near incidents" that occur in the MR site are reported to the medical director in a timely fashion (e.g., within 24 hours or 1 business day of their occurrence) and used in continuous quality improvement efforts. It should be stressed that the Food and Drug Administration states that it is incumbent upon the sites to also report adverse events and incidents to them via their MedWatch program. The ACR supports this requirement and feels that it is in the ultimate best interest of all MR practitioners to create and maintain this consolidated database of such events to help us all learn about them and how to better avoid them in the future (Kanal, E., 2007).

NSF/NFD is a painful, debilitating, and deadly condition that has no cure or treatment. Therefore, people are becoming affected with an….....

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