Nursing care of patients with contrast media extravasation

Authors

  • Jittranun Kongwong Faculty of Medicine, Siriraj Hospital, Mahidol University
  • Poonsap Sutewee Faculty of medicine, Siriraj Hospital, Mahidol University
  • Aunyamanee Wangkeeree Faculty of medicine, Siriraj Hospital, Mahidol University

Keywords:

contrast media, contrast media extravasation, nursing, prevention

Abstract

Contrast media extravasation is an adverse event of intravenous contrast media injection, which occurs in patients undergoing computed tomography (CT) with contrast media. Its impacts ranged from mild to severe effects. It may lead to the development of high muscle pressure, resulting in cell death and ischemia in affected area. Nurses play an important role in assessment, prevention, and provision of nursing care when contrast media extravasation occurs. Therefore, nurses require knowledge, skills, experience, and expertise in taking care for patient safety and reducing complication severity when this adverse event arises. The authors have summarized knowledge from relevant literature review combined with work experience to guide the readers to have sufficient competence to take care of patients undergoing CT with contrast media injection, which in turns, be able to provide care for these patients properly, safely and effectively.

References

Johnston A. Lodinated contrast media. Radiopaedia [Internet]. 2021 [cited 2021 Jun 2]. Available from: https://radiopaedia.org/articles/iodinated-contrast-media-1.

Chaopathomkul B, Ruxrungtham K, Leelanukrom R, Avihingsanon Y, Khovidhunkit W, Sunthornyothin S, et al. Clinical practice guideline for contrast media administration in diagnostic imaging. Chula Med J 2010;54(4):375–90. (in Thai)

Thailand Nursing and Midwifery Council. Nursing and midwifery council announcement. Prohibiting drugs or intravenous solutions [Internet]. 2021 [cited 2021 Jun 1]. Available from: https://www.tnmc.or.th/images/userfiles/files/H015. pdf. (in Thai)

Andreucci M, Solomon R, Tasanarong A. Side effects of radiographic contrast media: Pathogenesis, risk factors, and prevention. BioMed research international. 2014; 2014: 1-21.

Baba Y, Radswiki. Contrast media extravasation. Radiopaedia [Internet]. 2021 [cited 2021 Jun 1]. Available from: https:/radiopaediaorg/articles/contrast-media-extra vasation.

Schwab SA, Uder M, Anders K, Heinrich MC, Kuefner MA. Peripheral intravenous power injection of iodinated contrast media through 22G and 20G cannulas: Can high flow rates be achieved safely? A clinical feasibility study. RoFo: Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin 2009; 181(4): 355-61.

American College of Radiology (US). ACR Manual on Contrast Media. Washington: The Institute; 2021.

Gial Via A, Oliva F, Spoliti M, Maffulli N. Acute compartment syndrome. Muscles, Ligaments and Tendons Journal 2015; 5(1): 18-22.

Pechar J, Lyons MM. Acute compartment syndrome of the lower leg: A review. J Nurse Pract 2016; 12(4): 265-70.

Wang CL, Cohan RH, Ellis JH, Adusumilli S, Dunnick NR. Frequency, management, and outcome of extravasation of nonionic iodinated contrast medium in 69,657 intravenous injections. Radiology 2007; 243(1): 80-7.

Shaqdan K, Aran S, Thrall J, Abujudeh H. Incidence of contrast medium extravasation for CT and MRI in a large academic medical centre: A report on 502,391 injections. Clinical radiology 2014; 69(12): 1264-72.

Dodson JA, Matlock DD, Forman DE. Geriatric cardiology: An emerging discipline. The Canadian journal of cardiology 2016; 32(9): 1056-64.

Hardie AD, Kereshi B. Incidence of intravenous contrast extravasation: Increased risk for patients with deep brachial catheter placement from the emergency department. Emergency radiology 2014; 21(3): 235-8.

Reynolds PM, MacLaren R, Mueller SW, Fish DN, Kiser TH. Management of extravasation injuries: A focused evaluation of noncytotoxic medications. Pharmacotherapy 2014; 34(6): 617-32.

Wienbeck S, Fischbach R, Kloska SP, Seidensticker P, Osada N, Heindel W, et al. Prospective study of access site complications of automated contrast injection with peripheral venous access in MDCT. AJR American journal of roentgenology. 2010; 195(4): 825-9.

Davenport MS, Wang CL, Bashir MR, Neville AM, Paulson EK. Rate of contrast material extravasations and allergic-like reactions: effect of extrinsic warming of low-osmolality iodinated CT contrast material to 37 degrees C. Radiology 2012; 262(2): 475-84.

Suwattananonkit T. Extravasation contrast media: Prevention and nursing care. Journal of Siriraj radiology 2015; 2(1): 64-70. (in Thai)

Siriapisith T. Techniques for computed tomography of vascular. Bangkok: Siriwattana Interprint Publishers; 2011. (in Thai)

Stowell JR, Rigdon D, Colglazier R, Filler L, Orosco D, Connell M, et al. Risk of contrast extravasation with vascular access in computed tomography. Emergency radiology 2020; 27(3): 253-8.

Sawasrak K, Chaiyabutra S, IV Care Team Committee Chaiyaphum hospital. The development of clinical nursing practice guideline for patients with peripheral intravenous catheters. Chaiyaphum Medical Journal 2018; 38(3): 50-60. (in Thai)

Pathomjaruwat T. Impact of a nursing care guideline on prevention and management of extravasation. Thai Journal of Nursing Council 2016; 31(2): 81-95. (in Thai)

Pathomjaruwat T. Prevention and management of extravasation in infusion therapy. Songklanagarind Journal of Nursing 2017; 37(2): 169-81. (in Thai)

Tonolini M, Campari A, Bianco R. Extravasation of radiographic contrast media: Prevention, diagnosis, and treatment. Current problems in diagnostic radiology. 2012; 41(2): 52-5.

Subcommittee of the national essential drugs, Expert committee on national drug selection in diagnostic radiology, Chaopathomkul B. Contrast medium. Bangkok: Aksorn graphic and design Publishers; 2013. (in Thai)

Sbitany H, Koltz PF, Mays C, Girotto JA, Langstein HN. CT contrast extravasation in the upper extremity: Strategies for management. International Journal of Surgery (London, England) 2010; 8(5): 384-6.

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Published

2021-12-29

How to Cite

1.
Kongwong J, Sutewee P, Wangkeeree A. Nursing care of patients with contrast media extravasation. JNSH [Internet]. 2021 Dec. 29 [cited 2024 Apr. 27];44(4):95-106. Available from: https://he01.tci-thaijo.org/index.php/nah/article/view/250248

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Section

Academic Article