Visual Aids Help Radiologists Manage Contrast Medium Reactions

Leesburg, VA, August 13, 2018—Radiologists who had access to a visual aid or flowchart reported being more confident in managing contrast media reactions than those without, according to an article set for publication in the American Journal of Roentgenology (AJR).

Administration of IV contrast agents can lead to a variety of adverse reactions ranging from urticaria to life-threatening anaphylaxis. However, the frequency of such adverse reactions is low, ranging from 0.2% to 0.7% for nonionic iodinated contrast media and 0.06% for gadolinium-based contrast media.

Because contrast medium reactions are rare, most radiologists have limited experience managing them, and more than 50% of radiologists do not know the correct dose of epinephrine to administer during a severe reaction.

In the study, radiologists and trainees were requested to participate in a contrast medium reaction simulation program, including a moderate-severity reaction scenario, and were randomized to groups having or not having a visual aid. The time to administer intramuscular (IM) epinephrine via automated injector and errors in administration were recorded. After the simulation, all participants completed a survey assessing their comfort in treating reactions to contrast media with and without a visual aid.

Errors in management occurred in 18.2% (2 of 11) of groups with visual aids versus 40% (4 of 10) in groups without, with epinephrine self-administration reflecting the most common error. Excluding the groups with errors, the mean time to administration of IM epinephrine was 97 seconds with versus 152 seconds without the visual aid. Of the 138 participants, 97.8% agreed that the visual aid poster would aid in medication administration, and 87% agreed that it would help decrease time to administer medications.

Founded in 1900, ARRS is the first and oldest radiology society in the United States, and is an international forum for progress in radiology. The Society's mission is to improve health through a community committed to advancing knowledge and skills in radiology. ARRS achieves its mission through an annual scientific and educational meeting, publication of the American Journal of Roentgenology (AJR) and InPractice magazine, topical symposia and webinars, and print and online educational materials. ARRS is located in Leesburg, VA.