Boston Scientific MRI Cardiology Order Form
The Boston Scientific MRI Cardiology Order Form is essential for healthcare professionals to safely proceed with MRI scans for patients with implanted cardiac devices. Proper completion ensures patient safety and device functionality during MRI procedures. This document provides guidelines for MRI protection mode programming and patient monitoring requirements.
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How do I fill this out?
To fill out this form, please begin by entering the patient's name and date of birth. Next, provide details about the implanted devices, including model numbers and lead locations. Ensure that all required fields are accurately completed before submission.
How to fill out the Boston Scientific MRI Cardiology Order Form?
1
Enter the patient's name and date of birth.
2
Select the type of device implanted (e.g., Pacemaker, CRT-D).
3
Fill in the model numbers and lead details.
4
Choose the appropriate MRI protection mode settings.
5
Review the form before submission.
Who needs the Boston Scientific MRI Cardiology Order Form?
1
Cardiologists need this form to ensure safe MRI procedures for patients with cardiac devices.
2
MRI technologists require this form to understand the patient's device settings before scanning.
3
Patient care coordinators must complete the form for scheduling MRI appointments safely.
4
Emergency room staff may need this form for patient identification during urgent care situations.
5
Nurses assisting in patient preparation for MRI need this form to double-check all details.
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What are the instructions for submitting this form?
To submit the MRI Cardiology Order Form, send it via email to the designated healthcare facility or department handling MRI procedures. You may also fax completed forms to the specified fax number provided in your facility's contact list. Ensure that all information is filled out correctly before submission to prevent delays or issues during the MRI process.
What are the important dates for this form in 2024 and 2025?
The Boston Scientific MRI Cardiology Order Form is valid until further notice but should be reviewed annually for updates. Keep an eye on relevant procedural timelines, especially for upcoming MRIs in 2024. Ensure all documentation is in order before any scheduled scans.
What is the purpose of this form?
The purpose of the Boston Scientific MRI Cardiology Order Form is to facilitate safe MRI procedures for patients with implanted cardiac devices. This document outlines necessary precautions and validations required to ensure patient safety and device integrity during scanning. By providing comprehensive information about the implanted devices, the form supports healthcare professionals in making informed decisions during MRI evaluations.
Tell me about this form and its components and fields line-by-line.
- 1. Patient Name: Enter the full name of the patient.
- 2. Date of Birth: Provide the patient's date of birth to verify identity.
- 3. Device Type: Specify the type of implanted cardiac device.
- 4. Model Numbers: List the model numbers of the implanted devices.
- 5. Pacing Parameters: Detail the pacing settings for the device.
- 6. Signature: Space for the physician's signature confirming the information.
What happens if I fail to submit this form?
Failing to submit this form can lead to delays in scheduling necessary MRI scans and potentially compromise patient safety. Accurate documentation is vital to ensure all safety protocols are followed. Without proper submission, healthcare professionals may lack crucial information about the patient’s cardiac devices.
- Scheduling Delays: Not submitting on time can delay MRI appointments.
- Safety Risks: Missing information may put patients at risk during scans.
- Inaccurate Device Settings: Failure to inform about device settings can lead to complications.
How do I know when to use this form?
- 1. Patient Preparation for MRI: Essential for documenting patient details and device specifics.
- 2. Pre-MRI Assessment: Used to verify that safety protocols are followed.
- 3. Emergency Situations: Necessary for clinicians in urgent care to understand the patient's device.
Frequently Asked Questions
How do I fill out the MRI Cardiology Order Form?
Begin by entering patient identification details, then specify the implanted device information and settings.
Can I edit the form once I've downloaded it?
Yes, you can edit the PDF on PrintFriendly before downloading it.
How do I share the completed form?
After editing, click on the share option to generate a link for sending to others.
Where can I find help if I'm unsure about filling out the form?
Refer to the Boston Scientific website or contact technical services for assistance.
Can I save my changes directly on the site?
While you can edit and download the form, currently saving directly on the site is not available.
How do I add my signature to the PDF?
You can click on the signature tool and place your signature directly on the document.
Is the PDF compatible with all devices?
Yes, PrintFriendly PDFs are compatible across various devices and browsers.
What is the purpose of the MRI Protection Mode programming?
MRI Protection Mode ensures that the device functions safely during imaging procedures.
How can I ensure the completed form is accurate?
Double-check all entries and consult with colleagues if you have questions before submission.
What should I do if I make a mistake in the PDF?
You can easily edit any mistakes directly on PrintFriendly before downloading.
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