Debunking Contrast Allergies

[Dr. Christopher Beck]:
Okay. So if we think iodine allergy should be removed, what should we be telling patients when they have an allergic reaction? So we'll go back to a scenario where a patient has an allergic reaction to a non-ionic or a recent contrast allergy, like during a CTA or whatever. What should we be telling that patient? Or what should we, as the physicians or some of the technologist, what should we be documenting?

[Dr. Cullen Ruff]:
The first thing you document is the actual contrast agent given by name, just like you would any antihypertensive or any antibiotic or any other drug that a patient has an allergic reaction to because what's most important is the next time this person needs a contrast injection, you can give them something different. We'll use penicillin G as the rogue antibiotic example here, if someone's allergic to penicillin G, and they need an antibiotic, what makes more sense to you: to give them the antibiotic that they're allergic to plus steroids to premedicate or does it simply make more sense to give them a different antibiotic that they've never had? And that's what we're going to discuss here. That's the same thing when it comes to contrast, we have to know by name what people have reacted to so that we can give them something different because giving people a different agent is the best way to prevent a future reaction much more so than steroid pre-medication.

[Dr. Christopher Beck]:
Another scenario, so if a patient has an allergic reaction and I'm going to use trade names as well, like Omnipaque 350, then if that patient comes back, having had a documented allergic reaction, you would recommend as the radiologists that, “Hey, let's try something different, like ISOVUE or Visipaque.” Is that right?

[Dr. Cullen Ruff]:
Absolutely. So ISOVUE, Visipaque, Optiray, Omnipaque, those are some of the most commonly used current low osmolar and lower allergenic agents. And yes, you would simply choose a different one.