Structured Training of Radiology Residents in the Management of Acute Intravascular Contrast Reactions

Purpose: Ensure adequate preparedness of radiology residents for the identification and management of intravascular complications of contrast agents. Establish an evidence-based protocol in all the clinical sites of an academic radiology practice.

Methods/Materials: The current study was a quality improvement initiative that included observation of resident physicians performing emergency safety protocols and related documentation. We then assessed the resident knowledge of contrast media complications, availability of emergency kits, safety protocols, and awareness of the clinic support staff.

Results: None of the residents were familiar with the specific code numbers in the event of an emergency. With regards to the availability of emergency kits, the location of the kits was not readily known nor who maintained the materials in the kits. Prior to the demonstration, confidence levels ranged from 16-40% on ten different subject areas. Post demonstration, confidence levels ranged from 50-80% on the same subject areas. No neonatologist on-call was readily available or known to the staff and residents in the case of a neonatal complication. A majority of the residents expressed high satisfaction with the training and high confidence in their ability to manage a catastrophic event, as evidenced by the increase in overall confidence levels surveyed pre and post the demonstration.

Conclusions: In summary, we identified knowledge and practice gaps in contrast reaction emergency preparedness training. Here, we propose a model of structured training and evidence-based practices to ensure the highest safety levels during procedures employing contrast media.