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X-Ray Orbits Ordering by Radiology Techs - Adult/Pediatric - Inpatient/Ambulatory/Emergency Department [154]

X-Ray Orbits Ordering by Radiology Techs - Adult/Pediatric - Inpatient/Ambulatory/Emergency Department [154] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Delegation/Practice Protocols, Ambulatory Delegation Protocols



Delegation Protocol Number: 154

Delegation Protocol Title:
X-Ray Orbits Ordering by Radiology Techs - Adult/Pediatric - Inpatient/Ambulatory/Emergency
Department

Delegation Protocol Applies To:
Radiology

Target Patient Population:
Adult and pediatric patients scheduled for an MRI

Delegation Protocol Champions:
Christopher Meyer, MD - Department of Radiology
Scott Reeder, MD - Department of Radiology
Venkata Meduri, MD - Department of Radiology

Delegation Protocol Reviewers:
Brian Sparland - Medical Imaging Manager
Carol Hassemer, MHA - Director of Clinical Operations/Medical Imaging
Carol Tomerlin - Radiology
David Dadds - Assistant Director, Business Services - Radiology
Kristi Klein - Manager, Radiology - MRI

Responsible Department:
Department of Radiology

Purpose Statement:
To delegate authority from the provider ordering the MRI to the MRI technologist to enter orders for X-
Ray Orbit/Skull Pre-MRI exams when the patient has indicated potential for ocular foreign body.

Who May Carry Out This Delegation Protocol:
MRI Technologists trained in the use of this protocol.

Guidelines for Implementation:
1. This delegation protocol is initiated when the patient is scheduled for an MRI and when the
screening form is marked “Yes” to the question: Have you ever sought medical attention to have
metal fragments removed from the eye?
2. The MRI technologist will review the patient’s record to locate any X-rays or CTs of the orbital area.
2.1. If images are found, the MRI technologist will contact the radiologist to review the images and
determine if an x-ray of the orbit is needed.
2.2. If no images are found the MRI technologist will determine if the provider ordering the MRI is a
UW Health provider.

Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
11/2017CCKM@uwhealth.org


2.2.1. If the prescribing provider is a UW Health provider the MRI technologist will order X-Ray
Orbits/Skull Pre-MRI (R70250A). Prior to placing any orders the MRI technologist will
review the patient’s medical record to determine if an active order for an x-ray of the orbit
has been previously placed to avoid duplication.
2.2.2. If the prescribing provider is not a UW Health provider, the MRI technologist will contact
the provider’s office to order the x-ray. If the non-UW Health provider is unavailable, the
MRI will not be performed and the patient will be rescheduled once the order for the X-
Ray Orbits/Skull Pre-MRI has been obtained from the provider.
3. The MRI technologist will wait to perform the MRI until the Radiologist confirms the x-ray shows no
metallic objects present in the eye.

Order Mode: Cosign Required, Protocol/Policy

References: NA
1. American Academy of Ophthalmology. Intraocular Foreign
Bodies. https://www.aao.org/bcscsnippetdetail.aspx?id=c6f21330-4e88-4b8d-8895-
37f1f7940011 Accessed December 7, 2016.
2. Kanal, MD, Emanuel, et. al. Journal of Magnetic Resonance Imaging. ACR Guidance Document on MR
Safe Practices: 2013. 37:501-5013. Accessed February 9, 2017.

Collateral Documents/Tools: UW Health Clinical Policy 2.3.4 Magnetic Resonance Imaging (MRI) Safety
and Screening

Approved By:
UW Health Ambulatory Protocol Committee: January 2017
Radiology – Gina Greenwood, Director of Radiology Services: February 2017
UW Health Center for Knowledge Management Council: February 2017
UWHC Medical Board: March 2017
UW Health Chief Medical Officer: March 2017

Effective Date: March 2017

Scheduled for Review: March 2020
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
11/2017CCKM@uwhealth.org