Avoiding Burns from Electrodes and Cables during MRI Exams (February 2007)

Posted on April 29, 2008

This story originally aired in February 2007. In this special edition of FDA PSN, we are repeating some of the most important safety issues that continue to pose a public health concern.

A recent FDA article in Nursing2006 describes second and third degree burns in patients undergoing MRI exams while they were wearing ECG electrodes and cables. Many of these burns were discovered only after the exam was over and some were severe enough to require plastic surgery.

The problem is that the radiofrequency fields created during an MRI exam can heat ECG cables and electrodes, seriously burning the underlying skin. This hazard is likely to increase as the number of MRI exams goes up, and as more patients need ECG monitoring during their MRI procedures.

The article recommends a number of ways to reduce the risk of these kinds of burns. Here are some of them:

• Remove any electrodes and cables that are no longer being actively used for monitoring. Search the patient for any electrodes and cables that may have been inadvertently left behind in clothing or sheets, or on the patient.

• If the patient needs ECG monitoring during the MRI procedure, check beforehand with the MRI staff to be sure that the cables and electrodes have been cleared for use in the MRI environment. If still in doubt, check with the manufacturer of these devices.

• Be sure that there is complete contact between the electrode surface and the patient's skin. If contact is poor - for example, if excess hair hasn't been removed or there's an air gap between the electrode and the skin - a serious burn can occur even if you are using electrodes and cables that are approved for MRI. Inadequate contact can also occur if the gel layer on the electrode has dried out, so avoid using electrodes that are past their expiration date and inspect each electrode before using it.

• Avoid looping and crossing the cables, because this can create excessive heat from resistance in the cable, which can burn the patient. Keep cables off the patient's skin by placing padding, such as a blanket, between the cable and the skin.

• After completing the MRI study, examine the patient for possible burns or reddening of the skin under the electrodes. This is especially important for patients who can't express themselves, or those who have impaired sensation. If the patient has a burn, administer appropriate treatment.

Additional Information:

Cables and Electrodes Can Burn Patients During MRI. Nursing2006, Volume 36, Number 11, p. 18.
http://www.fda.gov/cdrh/psn/show-60-electrodes.html