title: Avoidable errors in dealing with anaphylactoid reactions to iodinated contrast media.
abstract: Contrast reactions are much less common today than in the past. This is principally because of the current and predominant use of low and iso-osmolar contrast media compared with the prior use of high osmolality contrast media. As a result of the significantly diminished frequency, there are now fewer opportunities for physicians to recognize and appropriately treat such adverse reactions. In review of the literature combined with our own clinical and legal experience, 12 potential errors were identified and these are reviewed in detail so that they can be avoided by the physician-in-charge. Basic treatment considerations are presented along with a plan to systematize an approach to contrast reactions, simplify treatment options and plans, and schedule periodic drills.
authors.affiliation: Department of Diagnostic Imaging, Rochester General Hospital, Rochester, NY, USA. arthur.segal@rochestergeneral.org
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Segal
authors.forename: William H
authors.initials: WH
authors.lastname: Bush
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D000707:Anaphylaxis / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D001285:Atropine / Q000627:therapeutic use; D003287:Contrast Media / Q000009:adverse effects*; D004155:Diphenhydramine / Q000627:therapeutic use; D004632:Emergency Medical Services; D004837:Epinephrine / Q000627:therapeutic use; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control*; D010102:Oxygen Inhalation Therapy
chemical_list: D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D003287:Contrast Media; D006634:Histamine H1 Antagonists; D001285:Atropine; D004155:Diphenhydramine; D004837:Epinephrine