LibGuides: Nursing Grand Rounds resources for further reading.: Contrast Media Extravasation

This month's topic

Contrast Media Extravasation

BOOKS

Grainger and Allison's Diagnostic Radiology Essentials by Lee A. Grant; Nyree Griffin
Call Number: Print Book

ISBN: 9780702034480

Publication Date: 2013

Get the quick answers you need on every aspect of diagnostic radiology and apply them in your day-to-day practice. Grainger & Allison's Diagnostic Radiology Essentials serves as a comprehensive review and reference for radiologists in training and in practice by providing practical solutions to diagnostic problems in the radiological recognition and interpretation of a wide range of disease entities. Organized by body region, its innovative, accessible outline format, bullet point style and numerous, high quality, multi-modality images make essential key facts about any given condition easy to find and retrieve. The content follows the same order and is derived from the renowned authoritative reference work Grainger & Allison's Diagnostic Radiology. "The authors deserve to be congratulated on their gargantuan efforts and I am sure this textbook will be well thumbed by future radiology trainees preparing for their examinations." RAD Magazine, Nov 2013 Find the answers you need quickly and easily using the synoptic, bullet point format and structure. Every section is organised consistently to include Definition, Clinical Findings, Radiological Findings and Pearls. Efficiently review the key radiological features of a broad spectrum of disease entities - all images are linked to the text on the facing page. Avoid potential pitfalls in diagnosis by referring to the diagnostic "Pearls" sections in each chapter. Differentiate a full range of normal and abnormal findings with more than 3,000 images, including plain film, CT, MRI, ultrasound and nuclear medicine imaging. Keep hard-to-remember information and details at your fingertips with an extensive Appendix section including many 'quick reference' items that are essential in day-to-day practice (e.g. TNM staging). Access the entire text and images online, fully searchable, at Expert Consult.
Learning Radiology by William Herring
Call Number: Print Book

ISBN: 9780323567299

Publication Date: 2020

From the basics of patient safety, dose reduction, and radiation protection to the latest information on ultrasound, MRI, and CT, this concise, user-friendly text provides a complete, up-to-date introduction to radiology needed by today's students. Teaches how to arrive at a diagnosis by following a pattern recognition approach, and logically overcome difficult diagnostic challenges with the aid of decision trees.
The Unofficial Guide to Radiology: 100 Practice Chest X-Rays by Ali B. A. K. Al-Hadithi (Editor); Zeshan Qureshi (Editor)
Call Number: Print book

ISBN: 9780443109171

Publication Date: 2023-09-25

The unique and award-winning Unofficial Guides series is a collaboration between senior students, junior doctors and specialty experts. This combination of contributors understands what is essential to excel on your course, in exams and in practice - as well as the importance of presenting information in a clear, fun and engaging way. Packed with hints and tips from those in the know, when you are in a hurry and need a study companion you can trust, reach for an Unofficial Guide. This case-based guide teaches systematic analysis of chest X rays for everyone from complete beginners to professionals. Readers practise X ray interpretation on 100 high quality images based on real-life scenarios. Over each page is a model report accompanied by a fully annotated version of the X ray to explain the reasoning. 100 Practice Chest X Rays is ideal for students preparing for examinations and will also provide a handy reference for postgraduates and practising doctors. 100 high-definition images, just like real-life X-

Articles of Interest

Heshmatzadeh Behzadi, A., et al. (2018). "MRI and CT contrast media extravasation: A systematic review." Medicine 97(9): e0055 https://journals.lww.com/md-journal/fulltext/2018/03020/mri_and_ct_contrast_media_extravasation__a.24.aspx

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Background: This systematic review combines data from multiple papers on contrast media extravasation to identify factors contributing to increased extravasation risk. Methods: Data were extracted from 17 papers reporting 2191 extravasations in 1,104,872 patients (0.2%) undergoing computed tomography (CT) or magnetic resonance imaging (MRI). Results: Extravasation rates were 0.045% for gadolinium-based contrast agents (GBCA) and nearly 6-fold higher, 0.26% for iodinated contrast agents. Factors associated with increased contrast media extravasations included: older age, female gender, using an existing intravenous (IV) instead of placing a new IV in radiology, in-patient status, use of automated power injection, high injection rates, catheter location, and failing to warm up the more viscous contrast media to body temperature. Conclusion: Contrast media extravasation is infrequent but nearly 6 times less frequent with GBCA for MRI compared with iodinated contrast used in CT.

Kim, J. T., et al. (2020). "Guidelines for the management of extravasation." jeehp 17(0): 21-20 https://jeehp.org/journal/view.php?doi=10.3352/jeehp.2020.17.21 FULL ARTICLE AVAILABLE AT WEBSITE

The purpose of these practice guidelines is to offer and share strategies for preventing extravasation and measures for handling drugs known to cause tissue necrosis, which may occur even with the most skilled experts at intravenous (IV) injection. Herein, general knowledge about extravasation is first described, including its definition, incidence, risk factors, diagnosis, differential diagnosis, and extravasation injuries. Management of extravasation includes nursing intervention and thermal application. At the first sign of extravasation, nursing intervention with following steps is recommended: stop administration of IV fluids immediately, disconnect the IV tube from the cannula, aspirate any remaining drug from the cannula, administer drug-specific antidote, and notify the physician. Local thermal treatments are used to decrease the site reaction and absorption of the infiltrate. Local cooling (ice packs) aids in vasoconstriction, theoretically limiting the drug dispersion. Although clear benefit has not been demonstrated with thermal applications, it remains a standard supportive care. The recommended application schedule for both warm and cold applications is 15 to 20 minutes, every 4 hours, for 24 to 48 hours. For prevention of extravasation, health professionals should be familiar with the extravasation management standard guidelines. They should regularly check the extravasation kit, assess patients’ sensory changes, tingling or burning, and always pay attention to patients’ words. The medical team’s continuous education on extravasation is essential. With the practical use of these guidelines, it is expected to reduce the occurrence rate of extravasation and contribute to patient care improvement.

Liu, W., et al. (2023). "Contrast media extravasation injury: a prospective observational cohort study." European Journal of Medical Research 28(1): 458 https://journals.lww.com/md-journal/fulltext/2018/03020/mri_and_ct_contrast_media_extravasation__a.24.aspx FULL ARTICLE AVAILABLE AT WEBSITE

Objective: To identify the risk factors for moderate and severe contrast media extravasation and provide effective guidance to reduce the degree of extravasation injuries.

Methods: We observed 224 adult patients who underwent contrast media extravasation at Xiangya Hospital of Central South University, Hunan Provincial Maternal and Child Healthcare Hospital, and Xiangya Changde Hospital, Hunan Province between January 1, 2018 and December 31, 2022. Risk factors for moderate extravasation injuries were evaluated using univariate and multivariate logistic regression.

Results: Among 224 patients, 0 (0%) had severe, 18 (8.0%) had moderate, and 206 (92.0%) had mild contrast media extravasation injury. Multivariate logistic regression analysis revealed malignant tumors (odds ratio [OR] = 6.992, 95% confidence interval [CI]: 1.674–29.208), Iohexol (OR = 9.343, 95% CI 1.280–68.214), large-volume (> 50 mL) extravasation (OR = 5.773, 95% CI 1.350‒24.695), and injection site (back of the hand) (OR = 13.491, 95% CI 3.056–59.560) as independent risk factors for moderate injury.

Conclusion: Risk factors for moderate contrast media extravasation injury are malignant tumors, iohexol, large-volume (> 50 mL) extravasation, and back-of-the-hand injection. Analysis of these risk factors can help reduce the degree of injury after extravasation.

Clinical relevance statement: High-risk patients with extravasation support should choose the appropriate contrast media type, avoiding back-of-the-hand injections. We recommend that patients with cancer be implanted with a high-pressure resistant central venous catheter and receive effective measures to timely detect and reduce extravasation.

Roditi, G., et al. (2022). "Intravenous contrast medium extravasation: systematic review and updated ESUR Contrast Media Safety Committee Guidelines." European Radiology 32(5): 3056-3066 https://link.springer.com/article/10.1007/s00330-021-08433-4 REQUEST ARTICLE

Guidelines for management and prevention of contrast media extravasation have not been updated recently. In view of emerging research and changing working practices, this review aims to inform update on the current guidelines.

E-books

Fast Facts for the Radiology Nurse by Valerie G. A. Grossman
Call Number: E-Book

ISBN: 9780826129369

Publication Date: 2014

This portable guide to radiology nursing provides comprehensive information about this emerging specialty in a concise format designed for speedy information retrieval. Written for both practicing nurses and new orientees, it outlines general procedures and protocols, along with requisite information for patient care in specialized areas of radiology. It discusses care for all patient populations including morbidly obese, pediatric, geriatric, and oncology and addresses vascular access, infection control, teamwork, and sterile technique in the radiology setting. T
Interventional Radiology Cases by Bradley Pua (Editor); Allison Aguado (Editor); David Madoff (Editor); Anne M. Covey (Editor)
Call Number: E-book

ISBN: 9780199331277

Publication Date: 2015

In 104 cases featuring over 500, high-quality images, Interventional Radiology Cases is a thorough and accessible review of the interventional procedures that radiology residents are expected to be familiar with upon completion of residency and general radiologists need to know for recertification examinations. The cases present both benign and malignant conditions and all pertinent imaging modalities incorporated including: CT, MR, PET, fluoroscopy, and ultrasound. Part of the Cases in Radiology series, this book follows the easy-to-use format of question and answer in which the patient history is provided on the first page of the case, and radiologic findings, differential diagnosis, teaching points, next steps in management, and suggestions for furthering reading are revealed on the following page.

Nursing Grand Rounds resources for further reading.

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BOOKS

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