Screening for Contrast and Reactions

Barnes-Jewish Hospital

Monica White MBA, RT, R

Contrast Media Is a Drug

Drugs Given Over Time Verses a One-Time Bolus

Medication to Treat a Condition Verses to Visualize Structures

IV Medications Isotonic to Plasma Verses Contrast up to 7 Times More Osmolar

Typical Reactions to Contrast Media

Nausea and Vomiting Hives to Urticaria Hypotension Anaphylactic Reactions

Typical Reactions to Contrast Media

Vagal Reaction Cardiovascular Collapse- CARDIAC

ARREST Seizures or Convulsions

Risk Factors

General Patient Status History of Severe Allergy History of Asthma Renal Disease Age Multiple Myeloma Sickle Cell Anemia

Absolutely Absolutely NoNo Ionic Contrast Ionic Contrast

Should Be Used forShould Be Used for

Myelograms or SpinalMyelograms or Spinal

InjectionsInjections

CM-ARF

Pre-Existing Renal Insufficiency Diabetes Mellitus Dehydration Cardiovascular Disease and Diuretics Advanced Age Multiple Myeloma Hypotension Hyperemia

General Patient Preparation

History Hydration Handle It Heads Up

Pre Medication

Steroids (Prednisone or Hydrocortisone) Antihistamines (Benadryl-

Diphenhydramine)

Nonionic Contrast

Complications and Reactions

Nausea and Vomiting

Cool Cloth on Forehead

Slow the Rate

Compazine Hives and Urticaria

Observe Patients (IV Access Maintained)

Benadryl (Diphenhydramine)

Complications and Reactions

Bronchospasm

Inhaled Bronchodilators

Epinephrine

Subq or IM 0.1-0.5Ml1:1,000 (Vial)

Every 10-15 Minutes

IV: 1cc of 1:10,000 (Bristoject) IV Slowly

Complications and Reactions

Laryngeal Edema

Epinephrine

Benadryl or Histamine Blockers

True Medical Emergency

Complications and Reactions

Hypotension With Tachycardia

Check Blood Pressure

Elevate Legs

IV Fluids Under Physician's Supervision

Nurses in Area or Code Team

Complications and Reactions

Vasovagal Reaction

IV Fluids

Atropine (IV Push 0.5-1.0 mg)

May Be Repeated up to a Total of 2 mg

Complications and Reactions

Anaphylaxis, Circulatory Collapse and Shock

Call a Code

CPR

Being Prepared for an Emergency Check Procedure Room Replace Emergency Equipment Check and Know Where Crash Cart

Located If Unlocked Contents Replaced

Immediately Check Oxygen Tank

Being Prepared for an Emergency Defibrillator Checked Daily Designated Personnel Wall Outlets for Oxygen and Suction

Checked Daily; Oxygen and Suction Tubing

Know the Code Number

2-2700