If you hold MR safety responsibility, the ICU to MRI transfer is probably one of the harder things you have had to write local rules for. The stakes are high during this transition. Most of the equipment at the bedside cannot come through the door. While there has been national guidance covering MRI practice and anaesthesia, there has been relatively little guidance specifically addressing the transfer of critically ill patients to MRI. That changed with the fifth edition of the Intensive Care Society's Guidance On: The Transfer Of The Critically Ill Adult, published in April 2026.

It includes Chapter 26, on critical care patients requiring MRI. The chapter acknowledges directly that these transfers are often a cause of concern for nursing and medical staff because of the additional challenges involved.

We supply MRI monitoring and infusion equipment, so we acknowledge its contents from an equipment perspective. Below is what the chapter recommends on monitoring, infusion, ventilation and contrast access, with section numbers, followed by what else it covers. It is a summary rather than a substitute, and it is not clinical advice.

Monitoring

The guidance is specific, and it addresses the two things that make this pathway awkward: what you can measure, and where you can see it.

• Dedicated MRI-compatible monitoring with a slave screen in the control room should be used (26.5)
• For a Level 3 patient, that monitoring must provide ECG, invasive and non-invasive blood pressure, SpO₂ and waveform capnography at a minimum (26.5)
• Once in the control room, the escorting clinicians must be able to see the patient, the slave monitor, the ventilator and all infusion pumps (26.6)
• Elsewhere in the guidance, all monitors, ventilator displays and syringe drivers should be visible to accompanying staff (Recommendation 74)

Alongside these citations, there is another point to consider. Section 19.3, which covers monitoring on all transfers, lists the minimum for a Level 3 patient slightly differently: ECG, invasive or non-invasive blood pressure, SpO₂, waveform capnography and temperature. The two lists are not identical, which may reflect the additional practical considerations of MRI transfers.

Infusions and lines

This is where the chapter is most candid about what current practice costs.

• Infusions should be rationalised as much as possible, stopping non-essential infusions such as electrolytes, antibiotics and fluids (26.4)
• Those that continue should ideally be limited to three or four pumps, each with a sufficient length of MRI-compatible infusion line, with number and length varying by scan room layout (26.4)
• There is additional dead space in these lines, and supplementary medications should be available for at least double the duration of the transfer and scan, typically 60 minutes or more (26.4)
• Before entering the scanning room, syringes must be removed from infusion pumps unless a Faraday cage device is being used (26.6)
• Inside, the guidance suggests routing infusion lines, the ventilator circuit and the capnography sampling line down between the patient's legs and weighting them with a sandbag, noting that invasive line pressure bags contain small metal parts (26.6)

Ventilation

Notably, the guidance makes the case for dedicated MRI equipment on the grounds of continuity rather than compliance.

• Dedicated MRI-compatible transport ventilators are recommended, as they enable the patient to be established on the ventilator at the bedside and to remain on it throughout (26.5)
• Circuits must be long enough for the ventilator to sit where the manufacturer requires while the patient enters the bore head first, which typically means four to six metre circuits (26.5)
• Oxygen cylinders must be removed from the transport ventilator before entering the scanning room when an MRI-compatible ventilator is being used (26.6)
• Contrast access
• The patient should have a free site of access for contrast administration (26.4)
• This can be the central line flush line, if approved and compatible with power-injection equipment, or a 20G or larger cannula, ideally in the antecubital fossa (26.4)

The threshold, in both directions

MR Safety Week focuses attention on what happens inside the scanning room. Much of what Chapter 26 describes happens at the door. Syringes come out of pumps, cylinders come off the ventilator, and monitoring, ventilation and infusions are re-established once the patient is inside.

• It is common for invasive blood pressure and capnography not to be connectable until the patient is already in the scanning room (26.6)
• A team briefing before transfer is usually helpful, and some acute hospitals have a dedicated MRI checklist (26.6)
• A supervised test move of the patient into the scanner is recommended, to check the patient and lines are safe (26.6)
• On completion the reverse applies, with full monitoring, ventilation and infusions recommenced in the waiting area and stability confirmed before return to the unit (26.6)

Also in the chapter

• Escorts and staffing, including the requirement for two trained clinicians for sedated Level 2 and all Level 3 patients, and that junior inexperienced staff must not be required to undertake MRI scanning of critical care patients (26.2)
• Safety screening for patients and staff, staff induction with local radiography colleagues, and how to screen a patient who cannot be screened directly (26.3)
• Preparing a Level 3 patient typically takes 30 to 45 minutes, so preparation should begin around an hour before the scan (26.4)
• Intracranial pressure monitors, which need device-specific preparation (26.4)
• Emergencies, including cardiac arrest in the scanning room (26.7). We have not summarised that section here and it is worth reading in the original.

Where our equipment fits

We are the exclusive UK distributor for IRadimed, so this section should be read as us describing our own products.

The IRadimed Patient Monitor and Infusion Pump allow for monitoring the control room can see. The IRadimed 3880 MRI Patient Monitor pairs with a non-magnetic wireless remote tablet that mirrors the monitor and allows most routine functions to be operated from the control room, communicating through the MR shielding via a base station. It covers ECG, SpO₂, non-invasive blood pressure, capnography with waveform and fibre optic temperature, with invasive blood pressure through a separate 3883 wireless POD.

This piece of MRI-safe equipment allows for monitoring that travels. The 3880 mounts on a wall, roll stand, bed rail or anaesthetic trolley and detaches for transport, so the same monitor can be used at the bedside, on the way and during the scan.

Infusion closer to the patient happens with the MRidium 3860+ Infusion Pump system. It is a non-magnetic infusion system designed to operate inside the scanning room within its stated conditions, which can reduce the amount of extension tubing required compared with locating conventional pumps outside the MRI room.

A note on how the equipment is labelled. IRadimed describes both as non-magnetic designs. Both are labelled MR Conditional, and the conditions apply component by component rather than to the system as a whole. The monitor, wireless PODs, remote tablet, control room base station and multi-gas module do not all carry the same field limit. With any MRI equipment, ours included, it is worth checking the whole configuration against your own scanner's field map rather than a headline figure in a brochure. We can provide the current conditions for each component on request.

Both products comply with applicable UK medical device regulations and carry the appropriate conformity markings. We also supply IRadimed's Ferrous Metal Detector, and Medtron contrast injection systems for MR. On detection, it is worth knowing that MHRA treats ferromagnetic detection as an adjunct to thorough screening rather than a replacement for it.

Where to read more

• Intensive Care Society. Guidance On: The Transfer Of The Critically Ill Adult, 5th edition, April 2026. Chapter 26 covers critical care patients requiring MRI
• MHRA. Safety Guidelines for Magnetic Resonance Imaging Equipment in Clinical Use, v4.3, February 2021. The standard UK reference, including the roles of MR Responsible Person and MR Safety Expert
• Association of Anaesthetists and the Neuro Anaesthesia and Critical Care Society. Guidelines for the safe provision of anaesthesia in magnetic resonance units, 2019, in Anaesthesia
• ISMRM. MR Safety Week resources

Are you reviewing monitoring or infusion provision for critically ill patients needing MRI? We would be happy to assist on providing more information on our IRadimed portfolio, including on-site demonstrations, trials and service support.

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Liv Wiblin, Marketing Assistant, Probo Medical UK. Published 30 July 2026.