Tags

, ,

  • Bartlett MJ, Bynevelt M. Acute contrast reaction management by radiologists: a local audit study. Australasian Radiology 2003;47:363– 367.

    (Department of Diagnostic Imaging and Interventional Radiology, Royal Perth Hospital, Perth, Western Australia, Australia)

 

  • Consultant radiologists & trainees must possess knowledge of optimal acute management of contrast reactions because patient survival depends upon prompt initial management

  • Questionnaire
    1. What is the emergency telephone number at your institution to summon help in an emergency 7700
    2. Name the initial dose of Adrenaline
      1. Initial doses of adrenaline (1:1000) up to 0.75mg (Adult); Intramuscular is the preferred route of administration
    3. Name an Antihistamine and its dose
      1. Promethazine (Antihistamine) 0.5~1mg/kg
    4. Name a Corticosteroid and its dose
      1. Hydrocortisone 2~6mg/kg OR Dexamethasone 0.1~0.4mg/kg
    5. Name the dose of Atropine for profound bradycardia
      1. 0.3~0.6 mg
    6. What additional route for drug administration can be used in paediatric patients?
      1. Intraosseous route for drug & fluid administration
    7. What is the dose in joules for cardioversion of Ventricular Fibrillation?
      1. 200~360 J
    8. What are the rates of cardiac massage/minute for inadequate cardiac output?A. Cardiopulmonary Resuscitation (CPR): A universal compression to ventilation ratio of 30:2 is recommended.   With children, if at least 2 trained rescuers are present a ratio of 15:2 is preferred. In newborns a rate of 3:1 is recommended unless a cardiac cause is known in which case a 15:2 ratio is reasonable.
    9. Name a type of intravenous fluid for volume expansion in the hypotensive patient
      1. Normal saline
    10. Name the initial dose of Adrenaline for a paediatric patient.
      1. 10micrograms/kg for children
  • Anaphylaxis/anaphylactoid reactions are severe systemic allergic reactions that include one or both of two severe features: respiratory difficulty& hypotension.
  • The most important single medication in the treatment of anaphylactic/anaphylactoid reaction is adrenaline.
    • It is sympathomimetic leading to peripheral vasoconstriction, increased cardiac contractility & bronchodilation
  • Less-acute management, including corticosteroid & anti-histamine doses, were assessed