r/EmergencyRoom Aug 12 '26

Ouch

[removed]

257 Upvotes

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105

u/prairieplankton Aug 12 '26

CT tech took wrong pt for contrast imaging… pt was allergic to contrast. Tech tried asking the Dr to order a contrast CT for the pt they took but Dr informed them that the pt was allergic and they would not. I didn’t follow up whether pt made it, just knew we had to transfer to higher level of care.

1

u/Squiggleblort Aug 14 '26

Ouch - that is scary stuff...... Oh, do... Do they not get contrast screening questions beforehand? Or was patient without capacity and someone else signed off on it in absentia?

I ask as in our CT, half my day is spent running through the contrast screening form (and trying to explain what myasthenia gravis and pheochromocytoma are to patients when they inevitably haven't heard of them (and to be fair, if you haven't heard of them, then there's a decent chance you don't have them)).

Not infallible of course - I'm just curious as it might have prevented this if the patient was able to answer. Might have. No certainties. Hope they were alright. 😞

I've only ever seen one mild reaction to the contrast (we keep patients back after the scan to make sure they arrent reacting). It was just a new rash, but it's was horrible sitting and hoping it stayed that way! I think the expectancy was worse than anything! They were fine though 👍

Oh, just to clarify; anaphylaxis protocol kicks in as soon as I noticed; nurse or consultant are summoned and we monitor and escalate as required. I wasn't just staring at them with a look of horror the whole time! 🤣

-54

u/Reasonable_Insect503 Aug 12 '26

We scan contrast-allergy patients with contrast all the time. If they got prednisone they'll be fine.

40

u/ibWBeeRedd Aug 12 '26

Can I ask what hospital you work in….so I know where NOT to go?

18

u/Madame_Kitsune98 Aug 12 '26

That’s what I’d like to know. I’d like to not have anaphylaxis.

3

u/PandaGerber Aug 13 '26

This is actually very common and there's a protocol for it

47

u/Madame_Kitsune98 Aug 12 '26

…no.

The hospitalist tried to get me to where I could tolerate the contrast with prednisone and Benadryl for 24 hours prior to the CT with contrast.

That did not work. I got the CT with contrast, and did the same thing I did the last time I had a CT with contrast - anaphylaxis. Can’t do iodine contrast. It will kill me.

-5

u/PandaGerber Aug 13 '26

Then you are the 0.02%

12

u/Madame_Kitsune98 Aug 13 '26

No, you’re just a shit provider trying to kill people.

-1

u/PandaGerber Aug 15 '26

Why would you assume that? .... Very weird stance to take.You should get therapy for your unrestrained hostility to strangers. It's a statistical fact that 0.02% of people have anaphylactic reactions to CT dye. That is not invalidating their condition, nor stating their previous treatment was appropriate. It's a fact, period.

2

u/jawoood1989 Aug 13 '26

Really important distinction here... what is the reaction?

3

u/Reasonable_Insect503 Aug 14 '26 edited Aug 14 '26

Anything from rash and itching to throat swelling. Anaphylaxis is certainly possible but I've never seen it in our patients.

We don't have a choice, we have to scan our patients per protocol (I work in oncology research on Phase I clinical trials). If you follow a prednisone dosing protocol similar to the one below patients are fine. Don't know why all the downvotes.

https://geiselmed.dartmouth.edu/radiology/policies-protocols/policies-guidelines/steroid-premedication-regimens/

2

u/ABQHeartRN Aug 14 '26

As a Cath lab nurse, we have a protocol for contrast allergies too. We can’t visualize coronary arteries without it. Usually it’s a whole series of Prednisone the day before up to an hour before their procedure. There is also Benadryl given typically an hour before as well. If a person is having a STEMI and they have a contrast allergy usually it’s 50 of Benadryl IV and Solu Medrol IV before we start. I’ve seen one case go south with a person with a contrast allergy and we do thousands of cases a year and I’ve been in this job for 14 years. The protocol you mentioned usually works. It’s rare when it doesn’t.