Contrast reaction treatment

Question 1

Hives

Answer 1

Nothing
25-50mg diphenhydramine if symptomatic
180 mg fexofenadine alt

Question 2

Diffuse Erythema

Answer 2

IV access
Vitals
O2 6-10 LPM
Hypotensive - 1 L IV fluids

Question 3

Diffuse erythema with nonresponsive hypotension

Answer 3

epinephrine IV (1:10,000) -
1 mL (0.1 mg) slowly into a running infusion of IV fluids

Epinephrine IM - (1:1000), 0.3 mL (0.3 mg) (up to 1mg total)

911/rapid response

Question 4

Layngeal edema

Answer 4

Preserve IV
Give O2 6-10LPM
Epinephrine IM - (1:1000), 0.3 mL (0.3 mg)
-or-
Epinephrine IV (1:10,000) -
1 mL (0.1 mg)  up to 1mg epi

Question 5

Bronchospasm

Answer 5

IV
O2
Beta agonist inhaler (2 puff 90mcg /puff) up to 3 times
If severe or unresponsive - Epi

Question 6

Hypotension, Any Cause

Answer 6

IV
Vitals
Elevate legs
O2
IV fluids

Question 7

Hypotension with bradycardia

Answer 7

If mild, no additional treatment

If severe give atropine, 0.6 to 1.0 mg IV, into running IV infusion

Total atropine 3mg

Question 8

Hypotension with Tachycardia

Answer 8

Epi, same doses

Question 9

Unresponsive and pulseless

Answer 9

emergency response/ 911
CPR
Defib i possible
1 mg IV epi (1:10,000)

Question 10

Reaction Rebound Prevention

Answer 10

Hydrocortisone, 5 mg/kg IV over 1 to 2 minutes
or
Methylprednisolone, 1 mg/kg IV over 1 to 2 minutes.

Question 11

Epi dose and conc IM

Answer 11

IM - (1:1000), 0.3 mL (0.3 mg)

Total 1mg

Question 12

Epi dose and conc IV

Answer 12

Epinephrine IV (1:10,000) -
1 mL (0.1 mg)