Difference between revisions of "Contrast medium reaction"

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*'''Peripheral venous catheter''' and IV fluids are needed for everyone with anaphylaxis.<ref name=SURF/>
 
*'''Peripheral venous catheter''' and IV fluids are needed for everyone with anaphylaxis.<ref name=SURF/>
 
*Oxygen saturation, pulse and blood pressure are monitored.<ref name=SURF/>
 
*Oxygen saturation, pulse and blood pressure are monitored.<ref name=SURF/>
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In case of a '''contrast medium reaction''', a patient should be evaluated for the presence of the following symptoms and be medicated accordingly. Anaphylaxis is a more severe allergic reaction whose diagnostic criteria generally include low blood pressure and/or respiratory distress,<ref name="KimFischer2011">{{cite journal|last1=Kim|first1=Harold|last2=Fischer|first2=David|title=Anaphylaxis|journal=Allergy, Asthma & Clinical Immunology|volume=7|issue=Suppl 1|year=2011|pages=S6|issn=1710-1492|doi=10.1186/1710-1492-7-S1-S6}}</ref> and indicate the attention of an anesthesiologist or corresponding clinician on duty.
 
In case of a '''contrast medium reaction''', a patient should be evaluated for the presence of the following symptoms and be medicated accordingly. Anaphylaxis is a more severe allergic reaction whose diagnostic criteria generally include low blood pressure and/or respiratory distress,<ref name="KimFischer2011">{{cite journal|last1=Kim|first1=Harold|last2=Fischer|first2=David|title=Anaphylaxis|journal=Allergy, Asthma & Clinical Immunology|volume=7|issue=Suppl 1|year=2011|pages=S6|issn=1710-1492|doi=10.1186/1710-1492-7-S1-S6}}</ref> and indicate the attention of an anesthesiologist or corresponding clinician on duty.
  

Revision as of 16:39, 22 May 2018

Author: [notes 1]

This page in a nutshell:
  • Adrenaline, 0.3-0.5mg in adults, given intramuscularly, is the most important initial therapy.[1]
  • Peripheral venous catheter and IV fluids are needed for everyone with anaphylaxis.[1]
  • Oxygen saturation, pulse and blood pressure are monitored.[1]


In case of a contrast medium reaction, a patient should be evaluated for the presence of the following symptoms and be medicated accordingly. Anaphylaxis is a more severe allergic reaction whose diagnostic criteria generally include low blood pressure and/or respiratory distress,[2] and indicate the attention of an anesthesiologist or corresponding clinician on duty.

Symptoms[1] Medication[1] Route[1] Dosage[1] Time to effect[1] Repeat[1]
Adults Children
  • Severe hives
  • LRespiratory distress
  • Hypotension
  • Altered level of consciousness
  • Severe abdominal pains and vomiting
Injection of adrenaline Intramuscular in lateral thigh 0.3 - 0.5 mg
  • 0.01 mg/kg, up to 0.5 mg
    • 10-20kg: 0.15 mg
    • ≥20kg: 0.3 mg
Less than 5 min Every 5-10 min if needed
Asthma Salbutamol (Ventolin) or own bronchodilator Inhalation
  • 5 mg
  • Usually 4-6 doses
  • 2-6 doses
Less than 5 min Every 10 mins if needed
Hypoxia Oxygen Mask >5 l/min Almost immediate Continuous
Altered level of consciousness or hypotension Volume expander such as Ringer's IV with pressure 20mg/kg Fast As needed
All anaphylaxis cases Antihistamine such as desloratadine (Clarinex/Aerius) Oral 10mg of desloratadine
  • <6 years: 2.5mg desloratadine
  • 6 - 12 years: 5 mg desloratadine
Within 30-60 minutes Usually not
All anaphylaxis cases Glucocorticoid such as betamethasone Oral or IV
  • 5-8 mg betamethasone
  • <6 years: 3-4 mg
  • ≥6 years: 5-8 mg
2-3 hours Usually not

References


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