Monitoring to Remote-Location Standards
🧭 The same standard as main theatre — no compromise
- Anaesthesia in a remote location must meet the same minimum monitoring & safety standards as the operating theatre (AAGBI): a trained anaesthetic assistant, full monitoring including capnography, SpO₂, ECG, NIBP & temperature, oxygen supply & scavenging, and full resuscitation equipment.
- Use MR-conditional monitors; the ECG is distorted (magnetohydrodynamic T-wave change) — rely on SpO₂ & capnography as the primary signals.
- Monitors and the anaesthetist may be in the control room (Zone III) viewing through the window / repeater screen — plan how you will see the patient and displays.
- Have a reliable communication plan and a clear route to summon help.
The Golden Rule of MRI Emergencies
Patient deteriorates / cardiac arrest in the scanner
Recognise & call for help; stop the scan
EVACUATE the patient out of Zone IVMove to a safe area (Zone III / resuscitation room) — you cannot bring the ferromagnetic resus trolley, defibrillator or standard equipment into the magnet room
Full resuscitation outside the fieldDefibrillation, standard ALS & airway management in the safe area
Quench — venting the helium to de-energise the magnet — is reserved for the rare catastrophe (e.g. a person pinned by a large projectile, fire). It is slow, hazardous (asphyxiation/frostbite) and damages the scanner — it is not the routine response to an arrest. The routine response is evacuate the patient.