Unit Project on the development and implementation of the Turbo Reaction Box.
As described in my summary of this unit project, one anaphylactic reaction is enough. It is rare that this actually happens, however you always need to be prepared for the worst case scenario. Here at UCH, our reaction rate is very low. We are below the national benchmark that is set by the American College of Radiology (ACR) and the UCH consorstium. I have attached a breakdown of the number and percentages of contrast reactions in radiology for the years 2011, 2012 and 2013 up to July. We only had three anaphylactic reactions and they all fell in 2011. It was so strange to have so many in a row that we started keeping track of the specific lot numbers of the contrast to see if there was any correlation. We did not find any correlation with any specfic lot number of contrast. One of these patients had been pre-medicated with the standard thirteen hour prep, which includes three doses of Prednisone and one dose of Benadryl. For the majority of reactions, nothing needs to be done. The symptoms resolve on their own after about 30 minutes.
In order to prevent a poor outcome from what is an expected but rare complication (anaphylaxis) of IV contrast used in radiologic exams, it is important to have appropriate medications readily available and the staff and providers trained.
As described in my summary of this unit project, one anaphylactic reaction is enough. It is rare that this actually happens, however you always need to be prepared for the worst case scenario. Here at UCH, our reaction rate is very low. We are below the national benchmark that is set by the American College of Radiology (ACR) and the UCH consorstium. I have attached a breakdown of the number and percentages of contrast reactions in radiology for the years 2011, 2012 and 2013 up to July. We only had three anaphylactic reactions and they all fell in 2011. It was so strange to have so many in a row that we started keeping track of the specific lot numbers of the contrast to see if there was any correlation. We did not find any correlation with any specfic lot number of contrast. One of these patients had been pre-medicated with the standard thirteen hour prep, which includes three doses of Prednisone and one dose of Benadryl. For the majority of reactions, nothing needs to be done. The symptoms resolve on their own after about 30 minutes.
In order to prevent a poor outcome from what is an expected but rare complication (anaphylaxis) of IV contrast used in radiologic exams, it is important to have appropriate medications readily available and the staff and providers trained.
The value added through this project was preparing my department for future anaphlaxis by having first line medications (Epinepherine) readily available for the staff and providers that are trained to respond in a timely and proficient manner to these reactions.
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unit_project.docx | |
File Size: | 19 kb |
File Type: | docx |
The contrast _reactions.pdf file and the jacr_article.pdf file are the attachments referred to in the unit_ project.docx file.
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contrast_reactions.pdf | |
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The references.docx file are the references used for developing the algorithm and the pocket card.
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references.docx | |
File Size: | 15 kb |
File Type: | docx |
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jacr_article.pdf | |
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Before we even began on this journey, I did a search of the literature and found articles related to IV contrast reactions (how to respond and the first line medications to treat these reactions) and how to use the EpiPen. Not all of the articles in the literature search were strict studies, just good information from experts in their field. In the file below, is my data from some of these articles. The above references.docx file is also a list of references used for this project.
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raw_data_from_literature_research.pdf | |
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This is data collected from the dash board from our QA Committee and put into an excel spread sheet.
Once Dr. Restauri and I had all the data we needed, I began the process of finding the right box and filling the boxes with the medications. I wanted something to hang on the wall with easy access and yet be able to be secure and tamper resistant. I started looking through catalogs to find the right box. I knew what I wanted, just needed to find the right one. Please see the attached file to be able to comprehend the process of having the boxes made and ordered. It actually took about 6 months to get these boxes in.
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ordering_reaction_boxes.pdf | |
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There was alot of communication with regards to the boxes and the whole concept of these boxes and the training that had to be dissemninated to the stake holders.
Radiology QA Committee Agenda and Minutes showing my participation.
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feb._qa_committee_minutes.pdf | |
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reaction_boxes_and_qa_committee.pdf | |
File Size: | 403 kb |
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communication_on_medications.pdf | |
File Size: | 72 kb |
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