Document Detail

Acute contrast reaction management by radiologists: a local audit study.
MedLine Citation:
PMID:  14641186     Owner:  NLM     Status:  MEDLINE    
Consultant radiologists and trainees must possess knowledge of optimal acute management of anaphylactic/anaphylactoid contrast reactions because patient survival depends upon prompt initial management. The aim of the present study is to assess the knowledge of first-line management of these reactions among radiologists. Within one working day, and without prior knowledge, radiology consultants and trainees within four teaching hospitals in a major Australian capital city were asked to complete a confidential questionnaire regarding acute resuscitation management. Scenarios were presented of an adult who developed life-threatening symptoms of anaphylaxis immediately after intravenous contrast administration, ventricular fibrillation and profound bradycardia. Questions were asked with regards to adrenaline, corticosteroid, antihistamines, intravenous volume expansion, cardio-pulmonary rescuscitation and knowledge of the emergency telephone number. Sites were assessed for presence of an anaphylaxis management chart and also when each participant last completed a resuscitation course. Forty-two participants were recruited. Overall, 53% of questions were answered correctly. Only 43% knew the adrenaline dose and if an incorrect dose was administered it was more likely to be an overdose. Notable inadequacies were also discovered with corticosteroid, atropine, antihistamine doses and intravenous fluid use. Only 26% had completed a resuscitation course in the past 2 years. Forty-five percent knew the emergency telephone number and 55% of rooms using intravenous contrast contained an immediately visible chart for contrast reaction management. Radiologist and trainee knowledge of immediate life-threatening contrast reaction management is deficient. Severe contrast reactions are uncommon with today's use of non-ionic contrast, but they still occur. Experience in the management of anaphylaxis can only come from regular, compulsory training.
Murray J Bartlett; Michael Bynevelt
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Australasian radiology     Volume:  47     ISSN:  0004-8461     ISO Abbreviation:  Australas Radiol     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2003-12-03     Completed Date:  2004-02-13     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0047441     Medline TA:  Australas Radiol     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  363-7     Citation Subset:  IM    
Department of Diagnostic Imaging and Interventional Radiology, Royal Perth Hospital, Perth, Western Australia, Australia.
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MeSH Terms
Acute Disease
Anaphylaxis / chemically induced*,  prevention & control*
Clinical Competence*
Contrast Media / adverse effects*
Radiology / education,  standards*
Reg. No./Substance:
0/Contrast Media

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