Acute contrast media reactions can range in severity from mild discomfort to life-threatening anaphylaxis. Three percent of all patients receiving intravenous (IV) contrast will experience reactions, although most will not require treatment. Severe, potentially life-threatening reactions occur in about 1 in 2,500 patients [1]. Overall, contrast reactions remain rare, particularly because of the widespread use of nonionic, low-osmolar contrast media. Because of the rarity of adverse reactions to contrast, many radiologists and hospital staff members remain unfamiliar with optimal treatments, appropriate medications, and their respective doses. Additionally, reaction training for nonradiology staff members covering after hours is not well established. Potential errors that commonly occur in the management of contrast reactions are a failure to recognize a contrast reaction; uncertainty regarding how to treat a reaction; failure to administer oxygen promptly; incorrect dosing or administration of epinephrine, atropine, and antihistamines; and an overall lack of advanced preparedness for the possibility of reactions [2 and 3].
Because of this concern for a lack of preparedness, other radiology departments have performed local audit studies or surveys, and often many of these management errors are identified [4 and 5]. In our quality improvement initiative, we assessed the readiness of our department and medical center both during and after hours in responding to acute contrast media reactions and identified areas for improvement to ensure proper and efficient treatment should a contrast reaction occur.