The patient is observed for any indications of contrast reaction throughout the administrative process. At the completion of the injection, the catheter is flushed with 10cc 0.9% normal saline, the high-pressure tubing is disconnected, and the IV site is inspected for any swelling or indication of extravasation.Contrast flow is manually tested to ensure patency. Otherwise, connect the fluid filled high-pressure tubing to the catheter at the hub closest to the catheter. If there is resistance, pain, or the catheter does not flush, do not proceed. The patency of the IV catheter is checked by flushing with 0.9% normal saline (using the injector at the same rate as the actual contrast injection).Before beginning injection, the RN/RT explains that these may occur and reassures the patient. Transient minor reactions such as warm flushing and altered sense of taste are common.Dosage is determined by scan protocol and body weight per manufacturer's recommendations. The RN/RT check orders for contrast administration, verify the five rights (right patient, right medication, right dose, right route, right time).The patient should be offered the opportunity to speak with a radiologist if questions persist or anxiety seems pronounced. The RN/RT questions the patient regarding their expectations, explains the iodinated contrast procedure and reassures the patient. Most patients have some degree of anxiety and fear concerning imaging procedures.The pharmacist may be consulted as necessary. The RN/RT reviews the completed form and notifies the Radiologist of any contraindications or serious risk factors noted.Upon arrival to the department, the patient completes the “Patient Screening Form For Iodinated Contrast.”.This protocol will be for the technologist to follow when performing the examination. The radiology team will review the imaging study order, determine whether the study requires iodinated contrast administration or not, and select an appropriate imaging protocol.An electronic order for an imaging study is placed by a referring physician in the electronic medical record.All areas where contrast is given must be equipped with emergency treatment supplies required for the treatment of common contrast reactions.Virtually all life-threatening reactions occur immediately or within 20 minutes after contrast injection. Most major and minor reactions will occur in patients without any known risk factors.Iodinated intravenous contrast media are pharmaceuticals and have potentially dangerous and life-threatening adverse reactions.The supervising physician must be physically present in the facility or office suite and available in order to provide immediate medical intervention to prevent or mitigate injury to the patient in the event of an adverse contrast reaction.In order to provide for the safe administration of contrast media, those persons administering contrast media and those performing the imaging procedures must have an understanding of indications for use of contrast media as well as the potential side effects (contrast reactions) and their management. This policy applies for all areas in the Department of Radiology and Biomedical Imaging where intravenous iodinated contrast media is given.
A Radiology nurse or a Radiology technologist may administer intravenous contrast media under the general supervision of a physician.
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