Survey of radiologists' knowledge regarding the management of severe contrast material-induced allergic reactions.
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.
Lightfoot
Christopher B
CB
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.
Abraham
Roshan Joseph
RJ
Mammen
Thomas
T
Abdolell
Mohamed
M
Kapur
Sandeep
S
Abraham
Robert J
RJ
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
D003287:Contrast Media; D004837:Epinephrine