Reactions and Complications
 | 1. How often do contrast reactions occur to IV contrast? Are there patients at increased risk? |
| 2. Although most iodinated contrast reactions are typically mild, what is the long term sequelae to the patient who gets a reaction? |
| 3. Are there specific patients or risk factors that make it more likely to get a contrast reaction? |
| 4. Will faster injection rates (5 cc/sec vs. 1 cc/sec) result in an increased incidence of contrast reactions? |
| 5. What are the categories of contrast reactions? |
| 6. Death is one of the potential complications of IV contrast. How often does this occur? |
| 7. What are the risks of IV contrast in terms of renal failure (CIN)? How often does CIN occur? How we prevent CIN? |
| 8. Who can not get IV contrast material? |
Allergic Reactions | |
| 1. Part 1: Can a patient get a rash from IV contrast? Can it occur 24-36 hours post CT study? |
| 2. Is it possible for a patient to get a delayed reaction to IV contrast? |
| 3. What if a patient is allergic to IV contrast material? |
 | Since non-ionic contrast has been widely utilized, the incidence of allergic reactions has decreased. However, some patients may still be allergic to IV contrast agents. Since we are unable to determine with any certainty which patients may have a reaction, it is only after a prior reaction that patients are usually pre-medicated. Some patients may have experienced a severe reaction to IV contrast, these patients may not be good candidates for premedication, but the importance of the scan needs to be weighed against the risk to the patient. In some instances clinicians and/or radiologists may decide to pre-medicate patients with a history of multiple allergies to other things as a precautionary measure. There are variations of pre-medications that are acceptable. However, if a pre-medication protocol is given, it usually involves giving corticosteroids and/or antihistamines. The dosage and time frames vary. These regimens have shown to be very helpful in reducing the risk of a recurrent reaction to the contrast. It is our protocol to give the patients 40 mg (PO) m of prednisone 24, 12 and 2 hours prior to the CT scan. For example, if a patient is to have a CT scan at 10 am on Monday. The 1st dose should be given at 10 am on Sunday, the 2nd dose at 10pm on Sunday and the final dose at 8 am on Monday. Of course members of the CT department need to be trained and able to handle an emergency situation in the event a patient does have an allergic reaction. |
| 4. Part 1: What patients are allergic to IV contrast? Part 2: Can we premedicate these patients and if yes what is our premedication protocol? |
| 5. Our patient needs the study now. What else can we do? |
| 6. The patient is allergic to shellfish or crabs. Can they get a IV contrast? |
Extravasation | |
| 1. What is contrast extravasation and how often does it occur? |
| 2. How do you prevent contrast extravasation? |
| 3. Part 1: How do we treat contrast extravasation when it happens? Part 2: Is cold compresses the rule or hot compresses? |
| 4. What if extravasation does occur. How often are there severe complication? |