Harbor:Creatinine screening prior to IV contrast
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- ED patients do NOT require creatinine measurement prior to IV contrast if the study is immediately necessary to prevent life-threatening decompensation or delay in emergent treatment (e.g., trauma patients, dissection r/o)
- DHS IV Contrast Expected Practices 10-2022
- Ok to give IV contrast if GFR>30
- No need for GFR screening if age <60 with no pertinent history (AKI, CKD, HD with urine output, renal transplant, Metformin use)
- If the GFR<30, ER physician should state in the CT order “Clinical History” or document in the chart that IV contrast is necessary and authorized.
- Alternately, the CT tech may call the physician to confirm IV contrast is necessary and authorized, and CT tech should document this communication in the chart.
- Screening for MRI contrast is unnecessary unless using Eovist for liver mets study (all ED Emergent studies should use Dotarem or Gadavist)