Christopher Bronson Lightfoot MD, Presenter: Nothing to Disclose

Thomas Mammen, Abstract Co-Author: Nothing to Disclose

Mohamed Abdolell MSc, PStat, Abstract Co-Author: Nothing to Disclose

Sandeep Kapur FRCPC, Abstract Co-Author: Nothing to Disclose

Robert Joseph Abraham MD, Abstract Co-Author: Nothing to Disclose

Severe contrast-induced allergic reactions can be fatal and rapid administration of epinephrine is the treatment of choice. We sought to evaluate radiologists’ knowledge for management of severe contrast-induced allergic reactions.

Following institutional research ethics board approval, we performed a telephone survey of radiologists working in Canada’s 13 English-speaking university-affiliated radiology departments. Based on a case scenario, radiologists were asked the initial medication of choice, then questioned on epinephrine for severe contrast-induced allergic reactions.

A total of 148 radiologists (30% target population, 88% response) were surveyed. Ninety-one percent (95% confidence interval [CI]: 86%, 95%) of radiologists chose epinephrine as the most important initial medication. No radiologist gave the ideal, but 39% (95% CI: 31%, 46%) gave an acceptable administration route, concentration and dose of epinephrine. Twenty-one percent (95% CI: 14%, 28%) of radiologists gave an overdose. Eight percent (95% CI: 4%, 13%) of radiologists knew which concentration of epinephrine was available in their drug kit/crash cart and what equipment is required to administer it to a patient.

Radiologists’ knowledge of epinephrine for management of severe contrast-induced allergic reactions is deficient.

Routine stocking of epinephrine auto-injectors is an attractive option to simplify and ultimately improve patient care in these emergency situations.

Lightfoot, C, Mammen, T, Abdolell, M, Kapur, S, Abraham, R, Management of Severe Contrast-induced Allergic Reactions by Radiologists: Why Not an EpiPen?.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5007584.html