A patient with a history of anaphylactoid reaction to allergens other than iodinated contrast does NOT need to be pre-medicated.
A patient should not receive contrast (iodinated oral or IV) if they have previously had an anaphylactoid reaction to non-ionic contrast unless, in the opinion of the physician, the procedure is needed as an emergency. Anaphylactoid reactions would include the following:
A patient may benefit from pre-medication if they have had a significant reaction to non-ionic contrast in the past. Significant reactions would include the following:
Significant reactions would NOT include the following:
The radiologist should discuss pre-treatment in these situations with the referring clinician.
If the referring clinician wishes the study to continue without pre-treatment this must be documented in the report.
If the referring clinician agrees that pre-treatment is warranted they should be advised to prescribe:
In an emergency setting an alternative faster (but less proven) regime is:
Pediatric Patients: (For patients less than 50kg):
In an emergency setting an alternative faster (but less proven) regime is:
Adapted from: American College of Radiology Contrast Media Manual, 1998 and Rad-LS (Bush, WH, Krecke KN, King BF, and Bettmann MA (eds.), Oxford University Press, Inc., New York, 1999