title: Vascular extravasation of contrast medium in radiological examinations: University of California San Diego Health System Experience.
abstract: BACKGROUND
  Extravasation is a well-recognized complication estimated to be between 0.1% and 0.9% of contrast medium administrations. According to the UC San Diego (UCSD) health system policy, all contrast medium extravasation (CME) reports are reviewed by the department of Risk Management, and the appropriate action is taken. Despite this strategy, a decrease in the incidence of CME could not be demonstrated.
  
  
  OBJECTIVE
  The aims of this study were to determine the frequency, management, and outcome of CME in UC San Diego patients and to assess the knowledge regarding CME among radiology technologists based on policy and guidelines. The secondary aim was to assess the manual ability of the radiology technologists in the performance of the procedure.
  
  
  METHODS
  The study has 2 parts; the first was retrospective, including data collection and interpretation of all radiology procedures using intravenous contrast medium injection between January 1, 2010, and September 30, 2011, and the second was prospective, including proactive observations and knowledge questionnaire.
  
  
  RESULTS
  There were 83 (0.48%) cases of CME of 17,200 patients, 54 women (0.64%) and 29 men (0.33%), P = 0.005. The patients with CME were older, and their cannula was inserted in other departments than Radiology Department, P < 0.000. There was a gap between the high theoretical knowledge that was found in the knowledge questionnaire and its implementation that was demonstrated in the proactive observation.
  
  
  CONCLUSIONS
  Our data demonstrate that sex, age, and where the cannula was inserted are predictive factors for CME. We believe that CME could be prevented by proper educational program and establishment of efficient strategy.
authors.affiliation: From the *Risk Management, Rabin Medical Center, Petach Tikva, Israel; and †Risk Management, and ‡Radiology Department, UC San Diego Health System, San Diego, California.
authors.forename: Galia
authors.initials: G
authors.lastname: Niv
authors.forename: Matthew
authors.initials: M
authors.lastname: Costa
authors.forename: Patricia
authors.initials: P
authors.lastname: Kicak
authors.forename: Katherine
authors.initials: K
authors.lastname: Richman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California; D057785:Catheters; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D003287:Contrast Media; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011872:Radiology Department, Hospital / Q000592:standards*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013679:Technology, Radiologic / Q000379:methods / Q000592:standards*; D055815:Young Adult
chemical_list: D003287:Contrast Media