Information required before administering pediatric IV contrast media

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#IVTEAM #Intravenous literature: “Questions pertained to information required before administering IV contrast media, types of central catheters for injecting IV contrast media, injection rates based on angiocatheter size and study type, and management of IV contrast media extravasation.” Callahan et al (2014).

Reference:

Callahan, M.J., Servaes, S., Lee, E.Y., Towbin, A.J., Westra, S.J. and Frush, D.P. (2014) Practice Patterns for the Use of Iodinated IV Contrast Media for Pediatric CT Studies: A Survey of the Society for Pediatric Radiology. AJR American Journal of Roentgenology. 202(4), p.872-9.

Abstract:

OBJECTIVE: There are limited data available on the use of IV contrast media for CT studies in the pediatric population. The purpose of this study is to determine the practice patterns of IV contrast media usage for pediatric CT by members of the Society for Pediatric Radiology (SPR).

MATERIALS AND METHODS: SPR members were surveyed regarding the use of IV contrast media for pediatric CT studies. Questions pertained to information required before administering IV contrast media, types of central catheters for injecting IV contrast media, injection rates based on angiocatheter size and study type, and management of IV contrast media extravasation.

RESULTS: The response rate of 6% (88/1545) represented practice patterns of 26% (401/1545) of the SPR membership. Most respondents thought the following clinical information was mandatory before IV contrast media administration: allergy to IV contrast media (97%), renal insufficiency (97%), current metformin use (72%), significant allergies (61%), diabetes (54%), and asthma (52%). Most administered IV contrast media through nonimplanted central venous catheters (78%), implanted venous ports (78%), and peripherally inserted central catheters (72%). The most common maximum IV contrast media injection rates were 5.0 mL/s or greater for a 16-gauge angiocatheter, 4.0 mL/s for an 18-gauge angiocatheter, 3.0 mL/s for a 20-gauge angiocatheter, and 2.0 mL/s for a 22-gauge angiocatheter. For soft-tissue extravasation of IV contrast media, 95% elevate the affected extremity, 76% use ice, and 45% use heat.

CONCLUSION: The results of this survey illustrate the collective opinion of a subset of SPR members relating to the use of IV contrast media in pediatric CT, providing guidelines for clinical histories needed before IV contrast media, maximum IV contrast injection rates for standard angiocatheters, contrast media injection rates for specific CT studies, and management of IV contrast media soft-tissue extravasation.

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