Contrast rxn/patient emergencies Flashcards Preview

Radiology oral boards review > Contrast rxn/patient emergencies > Flashcards

Flashcards in Contrast rxn/patient emergencies Deck (11)
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Facial or laryngeal edema or stridor

oxygen, epi 1:10,000 IV give 1mL, repeat up to 10 mL.
Low threshold for calling a code/intubation


hypotension with tachycardia, or shock

Oxygen, trendelenburg, put on monitors, give normal saline IV
If not responsive, give epi 1:10,000 IV up to 10mL
call code if not responding


hypotension with bradycardia

oxygen, trendelenburg, place on monitor
IV fluids, atropine 1.0 mg IV push
place pacemaker pads
repeat atropine or give epi 1:10,000 up to 10mL


mild-moderate urticaria

benadryl 50mg, watch for 30 minutes, pt should not drive himself home


Severe hypertension

place on monitors
Nitroglycerin 0.4mg tab sublingual
transfer to ICU



oxygen, consider valium or versed
get consult, call code if intubation needed


pulmonary edema

elevate torso, oxygen, five Lasix 40mg IV
transfer to ICU


Pt presents for MRI with gad but has kidney problems - how to proceed?

GFR 60+ good to go
GFR 45-59 low dose/half dose
GFR <30 avoid contrast if possible
if on dialysis, consider using gadovist or eovist and perform right before dialysis


Nephrogenic systemic fibrosis - discuss

Rare disease causing fibrosis (scarring) of the skin and other organs caused by gadolinium contrast exposure in patients with poor renal function.


How do you deal with metformin and CT contrast?

Stop metformin that day, don't resume until 48 hours later.


Pt has bronchospasm - what do you do?

oxygen, monitors
Beta-agonist inhaled (eg albuterol)
if unresponsive, give epinephrine SC or IM
if severe or persistent, call code team