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A re-audit of radiologists knowledge of Royal College of Radiologists current recommendations on the management of mild to severe contrast medium reactions.
EP33175
Poster Title: A re-audit of radiologists knowledge of Royal College of Radiologists current recommendations on the management of mild to severe contrast medium reactions.
Submitted on 18 Oct 2020
Author(s): William Brown, Helen Oliver, Rob Colliver
Affiliations: Royal United Hospitals Bath NHS Foundation Trust
Poster Views: 54
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Poster Information
Abstract: Background
Contrast medium reactions range from relatively common mild reactions to anaphylaxis; a severe, life-threatening, systemic hypersensitivity reaction. The RCR has endorsed the 2016 RANZCR Iodinated Contrast Guidelines which make recommendations for the immediate management of contrast medium reactions.

Radiology Departmental Advice
Staff who administer contrast should be trained in the recognition of contrast reactions, management of these reactions, and resuscitation. Patients having an anaphylactic reaction should be recognised and treated using the Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach. Drugs and resuscitation equipment should be readily available.

The Standard
100% staff correctly answering questions on management of contrast reactions.

Assess local practice
Radiology consultants and registrars in spring 2019 anonymously completed a questionnaire (RCR AuditLive Template). Teaching sessions with the Resus Team in autumn 2019 were arranged. Re-audit performed in May 2020.

Results
19 completed questionnaires, from 16 consultants and 3 registrars in the first audit. 19 completed questionnaires, from 15 consultants and 4 registrars in the second round.
The target of 100% answers from all staff being correct was not met in either round. The range of correct responses was 45.5 – 100% (mean 81.6), slightly improved from 36.3 – 100% (mean 73.9%) in the first round.

Conclusion
Ongoing re-audit following appropriate training after an interval of several months is recommended to ensure an improvement in staff knowledge about management of contrast reactions.
Summary: An audit designed to assess whether all radiology consultant and registrars know how to manage the range of mild to severe contrast medium reactions.References: Wang CL, Cohan RH, Ellis JH, Caoili EM, Wang G, Francis IR. Frequency, outcome, and appropriateness of treatment of nonionic iodinated contrast media reactions. AJR Am J Roentgenol. 2008 Aug;191(2):409-15.

Emergency treatment of anaphylactic reactions Resuscitation Council (UK) 2008  https://www.resus.org.uk/anaphylaxis/emergency-treatment-of-anaphylactic-reactions

The Royal Australian and New Zealand College of Radiologists. Iodinated Contrast Media Guideline. 2018. Available from: https://www.ranzcr.com/ search/ranzcr-iodinated-contrast-guidelines [accessed 12th Oct 2020]

The Royal College of Radiologists. Audit of Staff knowledge of Royal College of Radiologists current recommendations on the management of mild to severe contrast reactions. Available from https://www.rcr.ac.uk/audit/audit-staff-knowledge-royal-college-radiologists-current-recommendations-management-mild (accessed 12th Oct 2020]
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