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Contrast-Induced Emergencies

Emergencies in the radiology department

Contrast-induced emergencies

Contrast media

Contrast media are the substances used to enhance the image of internal anatomical structures during imaging investigations. Contrast media are used in radiological procedures such as X-ray, CT scan, MRI, and ultrasound.

Barium sulfate, water-soluble iodinated contrast, gadolinium-based contrast media and air as negative contrast media are some examples of types of contrast media. Iodinated contrast media are the main cause of the contrast-induced emergency, excreted by the kidney exclusively.

Type of reactions caused by contrast media– There are three types of reactions caused by contrast media:

Mild reactions

  • Nausea
  • Vomiting
  • Cough
  • Sneezing
  • Warmth
  • Headache
  • Shaking
  • Itching etc.

Moderate reactions

  • Tachycardia
  • Bradycardia
  • Hypotension
  • Hypertension
  • Pronounced cutaneous reaction
  • Wheezing

Severe reactions

  • Laryngeal edema
  • Convulsion
  • Arrhythmias
  • Cardiac arrest
  • Adverse reactions to contrast media

Adverse reactions

The adverse reactions are further classified into two groups:

  1. Acute adverse reactions

The acute adverse reactions occur within a few hours of the contrast administration

The cause of allergy-like reactions is the release of histamine from mast cells and basophils.

The majority of the acute adverse reactions are mild.

  1. Delated adverse reactions

The delayed adverse reactions may occur from 1 hour to 1 week of injection. In most of the cases, skin and subcutaneous tissue are affected.

Emergency drugs used in radiology

There are a lot of procedures are performed in the radiology department. Whenever there is sudden onset of any allergic reaction, after administration of contrast into patient’s body crash cart rushed for management.

The crash cart is the emergency trolley that contains life-saving emergency drugs and other equipment. The crash cart used in emergencies cases for the management of the crucial events.

The emergency drugs include:

  • Adrenaline- used for allergic reactions
  • Atropine- anti-arrhythmic drug
  • Buscopan- used to relief pain
  • Hydrocortisone- used for allergic reactions
  • Dopamine- used to increase blood pressure
  • Sodium bicarbonate- for electrolyte imbalance
  • Diazepam- for sedation
  • Avil- used as an anti-allergic agent

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