IV EXAM Flashcards
Radiographer
HCPC standards of proficiency: “be able to perform the full range of standard imaging techniques and contrast agent examinations
Intravenous contrast
- prescription only medicine
- administered to patients under a:
- PATIENT GROUP DIRECTION
- PATIENT SPECIFIC DIRECTION
Patient group directions
Written instructions for the supply or administration of medicines to GROUPS of patients who may not be individually identified before presentation for treatment. NOT A FORM OF PRESCRIBING and no specific training that health professionals need to undertake
- only specific groups can within a pgd such as radiographers
- healthcare assistants cannot administer under pfd
Patent specific direction
Direct written instruction for a named patient and unlike a Patient group direction, does not require assessment of patient by individual instructed before administering. If a radiologist writes the type, strength and amount of contrast agent to be given to a named patient then that is a PSD.
Should also include:
- name of patient
- Route of administration
- frequency
- date of treatment
- signature of prescriber
- type
- amount
- strength
Administering IV contrast
- required to fill in safety questionnaire
- only administered following verbal prient assessment
- pre and post procedure checks
- potential for adverse drug reactions
MHRA (medical and healthcare products regulatory agency)
- monitor new and existing drugs on the market
- new drugs to market are termed ‘black triangle drugs’
- should report suspected adverse drug reactions to IV contrast ( and others) through yellow card scheme
Yellow card scheme
- collects information on suspected problems or incidents involving:
- side effects / adverse drug reactions
- medical devise adverse reactions
- defective medicines
- Conterfiet or fake medicines or medical devices
- safety concerns for e-cigarettes or their refill containers
IV contrast agents / contrast media / dye
- Alters opacity of vessels, tissues and cavities within the body when using x-Ray, mri, ultrasound and other modalities
- can increase contrast difference between structures
- a chemical compound in a solution specific to each modality
- EG: Iohexol (active ingredient in omnipaque. 46% codine
Clinical significance of IV contrast media
- enhanced visibility of vascularised (perfused) structures
- allows enhanced localisation, visualisation and treatment of abnormalities disease and lesions
Intravenous vs intra arterial
- depends on anatomy being visualised and treatment being done
- consider risks. Intra arterial is more high risk
- radiographers tend to perform IV contrast exams
- radiologist and cardiologists tend to perform intra arterial exams
ADVERSE REACTIONS
An event that causes or has the potential to cause unexpected or unwanted effects involving the safety of patients, staff, users or other people
ADVERSE REACTIONS: record keeping
- who inserted cannula
- number of attempts to gain IV access
- record contrast type, name, volume, concentration, lot number.
- for reporting adverse reactions
- provides audit information for hospital patient safety records
ADVERSE REACTIONS
contrast extravasation
- complication of IV contrast media administration
- when contrast media leaks out of from vein to tissues under skin (subcutaneous rather than iv)
- can present as:
• increases swelling or pain
• increased redness (erythema)
• a change of sensation in affected area/ limb (paraesthesia)
• skin ulcering/ blistering
Can cause:
- tissue damage
- severe cases can require plastic surgery
- pump injections have highest risk
ADVERSE REACTIONS
Contrast extravasation: reducing risk
- ensure iodinated contrast media is warm prior to injection (20-37, 37° is ideal)
- ensure cannula is well aired in an appropriate vein ( ensure it is anchored with tegaderm)
- flushing cannula with saline and ask if they feel pain
- adjust flow rate of infusion
- monitor infusion
ADVERSE REACTIONS
Contrast extravasation: management
- stop injection immediately, disconnect from pump
- explain to patient: what you suspect and procedure
- inform on-call radiologist: to assess patient
- aspirate any residual drug: to extract as much of the drug as possible from site of extravasation, to reduce tissue damage
- pressure can be applied over site
- apply a compress
- elevate limb
- massage area gently
- provide aftercare leaflet
- Datix, report and document
