CT contrast media extravasation: Difference between revisions
| Line 21: | Line 21: | ||
*Ice pack to affected area | *Ice pack to affected area | ||
*Elevate | *Elevate | ||
*Consider hyaluronidase<ref>https://pubmed.ncbi.nlm.nih.gov/22633726/</ref> for iodinated contrast | *Consider hyaluronidase<ref>https://pubmed.ncbi.nlm.nih.gov/22633726/</ref> for iodinated contrast through the original IV to be given subcutaneously | ||
==Complications== | ==Complications== | ||
Revision as of 20:25, 23 November 2021
Background
- complication of contrast-enhanced CT scanning
- may also occur from MRI, but rare given low volume used
- Ultrasound-guided IVs are at higher risk[1]
Epidemiology
- ~0.5% (range 0.13-0.68%) of cases
Clinical Features
- Swelling and/or blistering at injection site
Differential Diagnosis
Contrast induced complications
- Contrast induced allergic reaction
- Contrast-induced nephropathy
- CT contrast media extravasation
- Nephrogenic systemic fibrosis
Evaluation
- Clinical (if no complication)
Management
- Stop infusion immediately
- Remove IV canula
- Ice pack to affected area
- Elevate
- Consider hyaluronidase[2] for iodinated contrast through the original IV to be given subcutaneously
Complications
- 97% have minimal or no injury
- 79% have localized swelling after extravasation
- 24% had pain
- Large volumes (> 50 mL) of high-osmolar contrast media = highest risk
- skin ulceration
- soft-tissue necrosis
- compartment syndrome
Disposition
May discharge after 2 hours with precautions if no signs of complications
See Also
External Links
References
- ↑ Dargin JM, Rebholz CM, Lowenstein RA, Mitchell PM, Feldman JA. Ultrasonography-guided peripheral intravenous catheter survival in ED patients with difficult access. Am J Emerg Med. 2010;28(1):1-7. doi:10.1016/j.ajem.2008.09.001
- ↑ https://pubmed.ncbi.nlm.nih.gov/22633726/