Contrast Reaction Simulation: An interdisciplinary teaching tool for radiology residents, fellows, attendings, nurses and technologists
Alisa Sumkin, Michael Magnetta, Marion Hughes1, Philip Orons2
1. Division of Neuroradiology, Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA
2. Division of Interventional Radiology, Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA
•Our goal was to develop a recurring training course to increase familiarity of the different types of contrast reactions and teach ACR based treatment algorithms to members of the healthcare team using a combination of standard didactic methods and simulation.
•Participants should be able to promptly recognize and treat contrast reactions utilizing an interdisciplinary approach amongst various healthcare workers.
•With the increase in medical imaging over the last several decades, there has been a subsequent increase in the use of contrast media.
•Acute adverse contrast reactions rarely occur with an estimated rate of 0.2-0.7%.
•These reactions can be life-threatening and with their infrequent occurrence, radiologists can feel unprepared.
•Familiarity with the spectrum of contrast reactions in a controlled simulated setting as well as increased baseline knowledge can help to better prepare radiologists for these events.
•We proposed that by using an integrative approach with technologists, nurses, residents, fellows and attending physicians, we could simulate a real-life scenario where a team approach can be utilized.
•Participant baseline contrast reaction knowledge was assessed with a 17 question multiple-choice pre-test.
•Participants then viewed an interactive online module containing information regarding the properties of IV contrast material, contraindications to administration of contrast agents and management of different contrast reactions.
•Participants then completed a two-hour simulation on 5 simulation dummies designed to mimic life-threatening contrast reactions.
•Technologists, nurses and all levels of physicians were included therefore the simulations were designed to reflect the actual roles of each healthcare provider’s position as part of the healthcare team.
•Following each simulation, participants were debriefed individually and then as a part of a large group.
•All participants completed the same 17 question post quiz.
•A total of 17 healthcare members (15 residents, 1 nurse practitioner and 1 attending physician) participated in the initial course.
•This included 12 junior level residents and 3 senior level residents.
•16 of the participants viewed the online training module prior to the simulation.
•The median score of the baseline knowledge quiz was 11 (65%, range: 7-14 [41%-82%]).
•The post median score was 13 (76%, range: 9-15 [53%-88%], p<0.001).
•100% of respondents preferred an in person simulation versus an online course alone (score of 8 or 9 out of 10).
We created an innovative, effective program, which emphasizes an integrative approach to teaching members of the healthcare team to recognize and treat contrast reactions using traditional didactic methods and simulation.
1.ACR Manual on Contrast Media, Version 10.2. ACR Committee on Drugs and Contrast Media, 2016
2.Beckett KR, Moriarity AK, Langer JM. Safe Use of Contrast Media: What the Radiologist Needs to Know. Radiographics 2015; Oct;35(6):1738-50