e. Allergy. If the patient indicates that he is allergic to iodine, that seafood
makes him sick, or that he had problems during a previous examination, the probability
of a reaction is increased. Regardless of the outcome of the questions, the specialist
should report his findings to the injecting physicians, preferably outside the exposure
room so that the patient cannot hear the conversation.
1-27. EMERGENCY TREATMENT OF REACTIONS
a. Emergency Equipment. Whenever iodinated contrast media are
administered intravenously, emergency equipment must be immediately available. This
equipment normally includes an emergency tray, a cut-down tray, and an oxygen
(1) Although the exact content of an emergency tray is determined by the
radiologist, it will include several sizes of needles, a variety of syringes, graduated sizes
of endotracheal or oropharyngeal airways, a blood pressure cuff, a stethoscope, a
tourniquet, intravenous fluids, and drugs. The needles and syringes are used to
administer the drugs; the airways are special tubes for maintaining an open air passage,
and the stethoscope and blood pressure cuff are used to monitor the patient's blood
pressure and heartbeat. A tourniquet is needed to locate a vein for injections,
intravenous fluids to raise blood pressure, and drugs to counteract the reaction.
(2) Some of the emergency treatment drugs may be cardiac stimulants such
as Epinephrine, blood pressure elevators like Levophed, and antihistamines such as
Benadryl. These are typical examples, but the radiologist may choose others.
(3) The oxygen therapy equipment is there to aid the patient's respiration. It
may be a Reuben (Ambu) bag (a device for pumping air into the patient's lungs) or an
oxygen bottle and mask.
Do not attempt to use this equipment unless you are specifically trained
(4) To maintain an open airway, a tracheotomy or cricothyroid puncture may
become necessary. For this purpose, cut-down trays or cricothyroid puncture needles
must be readily available.
(5) Do not try to administer any drugs nor perform any operations for which
you have not been fully trained. Such action may harm the patient and make you liable
for legal action.
(6) The radiologist will specify the items to be used as emergency
equipment, but you, the specialist, are responsible for its upkeep. Periodically check
the operation of the oxygen apparatus. Drugs and sterile packs must be up-to-date and
is good supply. If any items are used, they should be replaced as soon as possible.