CT contrast media extravasation: Difference between revisions
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==Background== | ==Background== | ||
* | *Complication of contrast-enhanced CT scanning | ||
** | **May also occur from MRI, but rare given low volume used | ||
*[[Ultrasound-assisted peripheral line placement|Ultrasound-guided IVs]] are at higher risk<ref>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</ref> | *[[Ultrasound-assisted peripheral line placement|Ultrasound-guided IVs]] are at higher risk<ref>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</ref> | ||
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*Ice pack to affected area | *Ice pack to affected area | ||
*Elevate | *Elevate | ||
*Consider hyaluronidase<ref>https://pubmed.ncbi.nlm.nih.gov/22633726/</ref> | *Consider hyaluronidase for iodinated contrast through the original IV to be given subcutaneously<ref>https://pubmed.ncbi.nlm.nih.gov/22633726/</ref> | ||
==Complications== | ==Complications== | ||
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==Disposition== | ==Disposition== | ||
May discharge after 2 hours with precautions if no signs of complications | *May discharge after 2 hours with precautions, if no signs of complications. | ||
==See Also== | ==See Also== | ||
Revision as of 11:12, 25 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 for iodinated contrast through the original IV to be given subcutaneously[2]
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/