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Screening for Contrast and Reactions Barnes-Jewish Hospital Monica White MBA, RT, R Contrast Media Is a Drug Drugs Given Over Time Verses a One-Time Bolus Medication to Treat a Condition Verses to Visualize Structures IV Medications Isotonic to Plasma Verses Contrast up to 7 Times More Osmolar Typical Reactions to Contrast Media Nausea and Vomiting Hives to Urticaria Hypotension Anaphylactic Reactions Typical Reactions to Contrast Media Vagal Reaction Cardiovascular Collapse- CARDIAC ARREST Seizures or Convulsions Risk Factors General Patient Status History of Severe Allergy History of Asthma Renal Disease Age Multiple Myeloma Sickle Cell Anemia Absolutely No Ionic Contrast Should Be Used for Myelograms or Spinal Injections CM-ARF Pre-Existing Renal Insufficiency Diabetes Mellitus Dehydration Cardiovascular Disease and Diuretics Advanced Age Multiple Myeloma Hypotension Hyperemia General Patient Preparation History Hydration Handle It Heads Up Pre Medication Steroids (Prednisone or Hydrocortisone) Antihistamines (BenadrylDiphenhydramine) Nonionic Contrast Complications and Reactions Nausea and Vomiting Cool Cloth on Forehead Slow the Rate Compazine Hives and Urticaria Observe Patients (IV Access Maintained) Benadryl (Diphenhydramine) Complications and Reactions Bronchospasm Inhaled Bronchodilators Epinephrine Subq or IM 0.1-0.5Ml1:1,000 (Vial) Every 10-15 Minutes IV: 1cc of 1:10,000 (Bristoject) IV Slowly Complications and Reactions Laryngeal Edema Epinephrine Benadryl or Histamine Blockers True Medical Emergency Complications and Reactions Hypotension With Tachycardia Check Blood Pressure Elevate Legs IV Fluids Under Physician's Supervision Nurses in Area or Code Team Complications and Reactions Vasovagal Reaction IV Fluids Atropine (IV Push 0.5-1.0 mg) May Be Repeated up to a Total of 2 mg Complications and Reactions Anaphylaxis, Circulatory Collapse and Shock Call a Code CPR Being Prepared for an Emergency Check Procedure Room Replace Emergency Equipment Check and Know Where Crash Cart Located If Unlocked Contents Replaced Immediately Check Oxygen Tank Being Prepared for an Emergency Defibrillator Checked Daily Designated Personnel Wall Outlets for Oxygen and Suction Checked Daily; Oxygen and Suction Tubing Know the Code Number 2-2700