Radiology Resident Resources

BWH/BWFH/DFCI Contrast Policies and Files

BWH Resident Tip Sheet for Intravenous Contrast

BWH/BWFH/DFCI Steroid Premedication Guidelines for Intravenous Iodinated Contrast Administration

Guidelines for Assessment and Premedication of Imaging Contrast Agent Allergies

Patient Home Care Instructions for Adverse Contrast Reaction (2018)

Management of Acute Contrast Reactions (2018)

Additional References

ACR Manual on Contrast Media (2020)

ACR Contrast Reaction Card (2020)

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When responding to a contrast reaction, please do the following things:

1. Fill out paper forms provided by the CT/MRI tech. These include an instruction sheet to the patient.
2. Place a note in Epic describing the reaction and any treatment/observation.
3. Update the allergies section of Epic with the reaction severity (i.e. mild/moderate/severe). It is important that we do this correctly as we base the need for allergy consult or restrict future contrast use based on this. Basically, most reactions are mild (i.e. hives, sneezing, subjective feeling of throat tightness), very few are moderate, and it is really unlikely that someone will have anaphylaxis.
4. If you talk with another MD (ordering provider, inpatient team) try to put in an ANCR if you can.