**3.1. The concept of safety screening**

It has been suggested that in dealing with safety issues the emphasis should be placed on prevention of accidents (Harding, 2010). This means measures need to be implemented to prevent accidents from occurring. Harding argued that even though total prevention of acci‐ dents is not achievable, every effort should be made to reduce their occurrences to the barest minimum. The concept of safety has a wider significance as safety is seen as a systemic ap‐ proach with thresholds that define the standard of safety (Elagin, 1996). In order to ensure an accident free, Elagin has suggested that an ordered procedure, which shows the level of safety in a particular environment should be followed. In recent times, concerns have been raised about the safety of the MRI facility due to the increasing number of MRI incidents by an alarming 185% over the last few years (Gould, 2008). Gould further suggested that there is need for a comprehensive safety programme for any health institution with a zero toler‐ ance for MRI errors. Several studies have shown that compromising patient safety have re‐ sulted in fatal consequences (Launders, 2005; Emergency Care Research Institute (ECRI), 2004). In 2005, Launders conducted an independent analysis of the Food and Drug Adminis‐ tration (FDA)'s Manufacturer and User Facility Device Experience Database (MAUDE) and gave a report on a database over a 10-year time span. This revealed 389 reports of MRI-relat‐ ed events, including nine deaths with three events related to pacemaker failure, two due to insulin pump failure and the remaining four related to implant disturbance, a projectile, and asphyxiation from a cryogenic mishap during installation of an MR imaging system. Vari‐ ous claims have been made in several publications which indicate that MRI accidents are largely due to failure to follow safety guidelines, use of inappropriate or outdated informa‐ tion related to the safety aspects of biomedical implants and devices and human errors (Shellock and Crues, 2004; New York Times, 2010; Healthcare Purchasing News, 2010). A panel under the auspices of the American College of Radiology (ACR) was constituted to address these critical issues. Kanal et al (2004) who were part of this panel pointed out that there was a continuous change in the use of the MRI as a technology with a drastic increase in the number of examinations done. They maintained that though there were safety guide‐ lines, the increased number of MR practitioners and the increased use of the technology for critically ill patients, contributed to the increasing incidence of mishaps occurring in MRI surroundings. According to McRobbie et al (2007), the overall objective of a safety procedure is to provide an appropriate standard of protection of patients and staff in the MRI unit, without unduly limiting the beneficial practices and also prevent the occurrences of tragic events in the MRI suite. MRI suites in clinical and hospital surrounding should establish safety protocols with an MRI safety officer designated to ensure that policies are implement‐ ed and adhered to (Kanal, 2004).
