title: Survey of radiologists' knowledge regarding the management of severe contrast material-induced allergic reactions.
abstract: OBJECTIVE
  To evaluate radiologists' knowledge of the appropriate management of severe contrast material-induced allergic reactions by means of a telephone survey.
  
  
  METHODS
  Institutional research ethics board approval was obtained. Following verbal consent, a telephone survey of radiologists working in Canada's 13 English-speaking and 13 U.S. university-affiliated radiology departments was performed. Participants were selected by using a multistage sampling scheme and simple random sampling within departments. Given a severe contrast material-induced allergic reaction case scenario, radiologists were first asked their initial medication of choice, then questioned specifically on the use of epinephrine. The Canadian and U.S. cohorts were compared by using the chi(2) and Fisher exact tests, as appropriate, and proportions and 95% confidence intervals (CIs) were computed.
  
  
  RESULTS
  A total of 253 (81%) of 311 radiologists from a 30% target population were surveyed. Ninety-one percent (231 of 253; 95% CI: 88%, 94%) of radiologists chose epinephrine as the most important initial medication. No radiologist gave the ideal response, but 41% (94 of 231; 95% CI: 35%, 47%) provided an acceptable administration route, concentration, and dose; 17% (n = 39; 95% CI: 12%, 22%) of radiologists provided an overdose. Only 11% (27 of 253; 95% CI: 7%, 15%) of radiologists knew what concentration of epinephrine was available in their drug kit and/or crash cart and what equipment would be required to administer it to a patient.
  
  
  CONCLUSIONS
  Radiologists' knowledge of epinephrine for the management of severe contrast material-induced allergic reactions is deficient.
authors.affiliation: Department of Diagnostic Radiology, Dalhousie University, QE II Health Sciences Centre, 1796 Summer St, Halifax Infirmary Site (Room 3316), Halifax, Nova Scotia, Canada B3H 3A7.
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Lightfoot
authors.forename: Roshan Joseph
authors.initials: RJ
authors.lastname: Abraham
authors.forename: Thomas
authors.initials: T
authors.lastname: Mammen
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abdolell
authors.forename: Sandeep
authors.initials: S
authors.lastname: Kapur
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Abraham
mesh_terms: D000707:Anaphylaxis / Q000139:chemically induced* / Q000517:prevention & control*; D002170:Canada; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D003287:Contrast Media / Q000009:adverse effects*; D004837:Epinephrine / Q000008:administration & dosage; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D011871:Radiology / Q000592:standards*; D011795:Surveys and Questionnaires
chemical_list: D003287:Contrast Media; D004837:Epinephrine