The safe administration of intravenous contrast material for urologists and radiologists

Safe administration of contrast media: what do physicians know?

BACKGROUND

Radiographic contrast media (RCM) are among the most commonly used materials in medicine. Nevertheless, there seems to be a little agreement between current practice and accepted guidelines regarding their adverse reactions, the indications for premedication, and use of low-osmolar contrast agents (LOCAs). Misconceptions exist regarding the relationship between hypersensitivity to RCM and foods and medications that contain iodine.

OBJECTIVE

To evaluate physicians' knowledge, misconceptions, and attitudes regarding the use of RCM and the prevention of their adverse reactions.

METHODS

Physicians from university-affiliated general hospitals were asked to complete an anonymous questionnaire on RCM.

RESULTS

A total of 157 physicians (45%), including radiologists, internists, pediatricians, surgeons, and primary family physicians, agreed to participate. All physicians demonstrated limited knowledge regarding adverse effects of RCM and the patients who might be at increased risk of developing them. Most physicians were not familiar with accepted guidelines for using premedication and LOCAs. Misconceptions regarding the association between the use of drugs or foods that contain iodine and adverse effects to RCM were common among all physicians.

CONCLUSIONS

The level of knowledge about the adverse reactions of RCM among physicians is unsatisfactory, which may result in unwarranted use of expensive LOCAs or premedication in healthy patients. Alternatively, physicians' failure to use these measures when indicated may endanger patients. Despite the lack of association between adverse effects to RCM and safe consumption of iodine-containing substances, physicians continue to harbor these misconceptions. Educational programs that may improve physicians' knowledge are urgently needed.

Constraste iodado em tomografia computadorizada: prevenção de reações adversas

A tomografia computadorizada tem sido um exame radiológico de ampla indicação e escolha para fins diagnósticos, principalmente na última década. No entanto, apesar de ser bastante elucidativo, em diversos casos, o procedimento oferece riscos associados à exposição à radiação e ao meio de contraste iodado. Sobre estas questões é escassa a disponibilidade de publicações na literatura de enfermagem. Assim, apresenta-se uma revisão bibliográfica, com ênfase na exposição ao contraste iodado e nas reações adversas que podem advir do seu uso. Além disso, são descritas as ações que os profissionais da equipe de saúde, alocados em serviços desta natureza, podem realizar para diminuir a ocorrência desses eventos adversos ou minimizar sua gravidade.