Lateral Transfers, Positioning Aids & Fall Prevention

Stretcher-to-Scanner Table Transfers: Multi-Person Lateral Slide

Transfer Modality Comparison in the MR Suite

For patients who are non-weight-bearing, comatose, immobilized, or heavily sedated, a lateral transfer using a rigid MR Safe slide board (smooth plastic transfer board) or friction-reducing slide sheet is mandatory.

Personnel and Staging Requirements

• Staffing and equipment: Use the facility safe-patient-handling assessment, patient size and mobility, trauma precautions, and the transfer-device instructions to select staff and mechanical assistance. Body mechanics alone do not make a heavy manual lift safe. Do not begin when the necessary trained team or MR-cleared device is unavailable.
• Table Height Adjustment: Position the stretcher parallel and flush against the MR scanner table. Lock all caster wheels on the stretcher. Adjust the height of the stretcher so it is level with, or slightly higher (1/2 inch) than, the scanner table surface. Transferring horizontally or slightly downward minimizes gravitational resistance; never pull a patient upward over a raised ledge.

Step-by-Step Multi-Person Execution

1. Log-Roll and Board Placement: With two assistants on the stretcher side, gently log-roll the patient onto their side away from the scanner table. Position the smooth plastic slide board beneath the patient's draw sheet, centering it under the patient's torso and pelvis. Roll the patient back down onto the board so they are resting smoothly across both surfaces.
2. Team Roles:
   • Receivers (Pullers): Two assistants position themselves on the far side of the MR scanner table. They reach across the table with palms up, grasping the heavy cotton draw sheet close to the patient's shoulders, hips, and knees.
   • Pushers: One or two assistants stand on the stretcher side to guide the patient and prevent them from rolling off the board.
   • Team Leader: The leader (typically stationed at the head of the bed supporting the cervical spine and managing endotracheal/IV lines) coordinates the movement.
3. Synchronized Transfer: The leader confirms all lines are clear and calls the cadence: "Ready, one, two, three, slide." On three, the pullers shift their body weight backward onto their rear legs, sliding the draw sheet and patient smoothly across the board in one continuous, unhurried motion, while pushers apply steady horizontal guidance.
4. Board Removal: Once the patient is safely centered on the scanner table, log-roll the patient slightly, extract the slide board, and smoothly lower the patient back to the supine position. Remove transfer aids unless the particular device is approved to remain in place for the examination. Check pressure protection and MR labeling; some systems have approved transfer boards or mattresses.

Fall Prevention Protocols & Scanner Table Safety

The MRI scanner table elevates significantly (often 3 to 4 feet above the floor) to align the anatomical region of interest with the magnet isocenter. Patients positioned on this narrow, elevated surface face severe fall risks.

• Non-Skid Footwear: All ambulatory patients must wear facility-provided non-skid (slip-resistant) socks or shoes during transfers.
• Table Safety Straps: Fasten the MR table's padded Velcro safety straps across the patient's thighs and midsection immediately upon positioning. Explain the aid and obtain cooperation. Whether an aid is a restraint depends on its purpose, effect, the patient's ability to remove it, and applicable policy—not its Velcro construction or name. Use restraint authorization and monitoring when indicated; never restrain merely to force scan completion.
• The Golden Safety Rule: Never leave an unstable, sedated, confused, pediatric, or elderly patient unattended on an elevated scanner table. Even turning away to adjust a console monitor or retrieve a coil from across the room can result in a fatal patient fall. Always lower the table or maintain physical contact until the patient is secured inside the bore.