Difference between revisions of "Contrast medium reaction"
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{{Nutshell|In a more severe reaction: | {{Nutshell|In a more severe reaction: | ||
| − | *'''Adrenaline''', 0.3-0.5mg in adults, given intramuscularly | + | *'''Adrenaline''', 0.3-0.5mg in adults, given intramuscularly.<ref name=SURF>{{cite web|url=http://www.mastcellssjukdom.se/wp-content/uploads/2015/12/Nationella_rekommendationer_%C3%B6verk%C3%A4nslighetsreaktioner_kontrastmedel__PDF_2014-10-17.pdf|title=Hypersensitivity reactions against contrast media - Swedish Society of Uroradiology [Swedish: Överkänslighetsreaktioner mot kontrastmedel – SURFs kontrastmedelsgrupp] ], 2014-10-17}}</ref> |
| − | *''' | + | *Summon an '''anesthesiologist''' |
| − | *''' | + | *Insert a '''peripheral venous catheter''' and give IV fluids.<ref name=SURF/> |
}}<br clear="all"> | }}<br clear="all"> | ||
| − | In case of a '''contrast medium reaction''', | + | In case of a '''contrast medium reaction''', 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> In anaphylaxis, intramuscularly administered adrenaline is the most important initial therapy.<ref name=SURF/> Also, an '''anesthesiologist''' or corresponding clinician on duty should be summoned. '''Oxygen saturation''', '''pulse''' and '''blood pressure''' are monitored.<ref name=SURF/> |
| + | |||
| + | In general in a contrast medium reaction, the patient should be evaluated for the presence of the following symptoms and be medicated accordingly.<ref name=SURF/> | ||
{|class="wikitable" | {|class="wikitable" | ||
Revision as of 21:12, 22 May 2018
Author:
[notes 1]
 In a more severe reaction: |
In case of a contrast medium reaction, anaphylaxis is a more severe allergic reaction whose diagnostic criteria generally include low blood pressure and/or respiratory distress.[2] In anaphylaxis, intramuscularly administered adrenaline is the most important initial therapy.[1] Also, an anesthesiologist or corresponding clinician on duty should be summoned. Oxygen saturation, pulse and blood pressure are monitored.[1]
In general in a contrast medium reaction, the patient should be evaluated for the presence of the following symptoms and be medicated accordingly.[1]
| Symptoms[1] | Medication[1] | Route[1] | Dosage[1] | Time to effect[1] | Repeat[1] | |
|---|---|---|---|---|---|---|
| Adults | Children | |||||
|
Injection of adrenaline | Intramuscular in lateral thigh | 0.3 - 0.5 mg |
|
Less than 5 min | Every 5-10 min if needed |
| Asthma | Salbutamol (Ventolin) or own bronchodilator | Inhalation |
|
|
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 |
|
Within 30-60 minutes | Usually not |
| All anaphylaxis cases | Glucocorticoid such as betamethasone | Oral or IV |
|
|
2-3 hours | Usually not |
References
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 . Hypersensitivity reactions against contrast media - Swedish Society of Uroradiology [Swedish: Överkänslighetsreaktioner mot kontrastmedel – SURFs kontrastmedelsgrupp ], 2014-10-17].
- ↑ Kim, Harold; Fischer, David (2011). "Anaphylaxis ". Allergy, Asthma & Clinical Immunology 7 (Suppl 1): S6. doi:. ISSN 1710-1492.
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