SHM Converge Scientific Abstract ePoster Gallery-Smarter Sedation: Evaluating a Minimal Sedation Protocol for Inpatient Mri

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This project evaluated an EMR-based minimal sedation protocol for inpatient MRI scans, designed to improve benzodiazepine dosing and reduce both under-sedation and over-sedation. The motivation was the lack of standardized protocols for MRI sedation, which can lead to incomplete scans or safety issues.<br /><br />An interdisciplinary team created a clinical pathway and order set for minimal sedation. The protocol guided clinicians to assess baseline vital signs, administer a benzodiazepine, reassess the patient, and either proceed with MRI, give a repeat dose (often half the initial dose), or escalate to anesthesia if needed. It included age-based dosing guidance for lorazepam, diazepam, and midazolam, with different oral and intravenous onset times and maximum doses.<br /><br />The study reviewed all cases where the order set was activated from March to October 2025. There were 30 cases in which benzodiazepines were given and MRI was attempted. MRI was successfully completed in 27 cases, a 90% completion rate. Patients had a mean age of 60 years, ranging from 21 to 92 years. The protocol was used for scans averaging 68 minutes in duration, with a maximum scan time of 216 minutes.<br /><br />The results suggest that the protocol was effective in achieving adequate sedation for MRI completion while maintaining safety. Importantly, there were zero reported safety events. The protocol also appeared useful across a broad range of patient ages and scan lengths, and it was applied in some non-MRI indications as well.<br /><br />Overall, the study supports that a structured, EMR-based minimal sedation pathway can improve the safety and effectiveness of inpatient MRI sedation, with clear escalation to anesthesiology when minimal sedation is not sufficient.

Asset Subtitle

Vinh-Tung P. Nguyen

Meta Tag

Author List Mackenzy Scott, Maria Vezina, Rebecca Tejiram, Vinh-Tung P. Nguyen, Yaakov Beilin

Category Innovations

Concept Minimal Sedation Protocol

Concept Inpatient MRI

Concept Benzodiazepine

Concept MRI Completion Rate

Concept Patient Safety

Distinguished Non-Finalist

Presenter Organization Division of Hospital Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai

Presenting Author Vinh-Tung P. Nguyen

Track Quality Improvement

Keywords

EMR-based sedation protocol

minimal sedation

inpatient MRI

benzodiazepine dosing

MRI completion rate

under-sedation

over-sedation

lorazepam

midazolam

anesthesia escalation

Minimal Sedation Protocol

Inpatient MRI

Benzodiazepine

MRI Completion Rate

Patient Safety