Access to a visual aid boosts the confidence of radiologists as they manage contrast medium reactions, according to a new study published in the American Journal of Roentgenology. It also led to a slight drop in errors and helped participants administer intramuscular (IM) epinephrine more quickly.
“Clinical decision algorithms are commonly used in health care, particularly in emergent clinical situations,” wrote author James B. Gardner, MD, of Yale-New Haven Hospital in New Haven, Connecticut. “These algorithms provide instruction on how to best treat a patient for a given clinical problem. Providing these algorithms in visual aids can expedite clinical decisions when time is critical, such as in the setting of a reaction to contrast media. Errors in management of these situations are common, and errors in epinephrine administration can result in life-threatening events.”
The authors had a total of 138 attending radiologists and trainees participate in a contrast medium reaction simulation program. Eleven groups of participants had a visual aid, and 10 did not.
Overall, errors in contrast medium reaction management occurred in more than 18 percent of groups with visual aids. Errors occurred in 40 percent of the groups without them. In addition, more than 97 percent of participants said the visual aid would be helpful during medication administration, and 87 percent said it would help decrease the time it takes to administer medications.
“Our study found high rates of self-administration errors with automated epinephrine injectors in groups without and with a visual aid during a simulated contrast medium reaction event, emphasizing the need for continued education in usage of these devices,” the authors wrote. “The visual aid was associated with higher subjective confidence of participants in contrast medium reaction management but resulted in a reduction in observed error rate that was not statistically significant.”
Gardner et al. also noted that groups using the visual aid “showed a tendency toward quicker IM epinephrine administration.” Groups using the visual aid had a mean administration time that was 25 seconds faster than those not using the visual aid.
“Although the difference did not achieve statistical significance, it may be clinically significant in management of anaphylactic contrast media reactions for which prompt administration of epinephrine is key in proper management,” the authors wrote. “This tendency toward quicker epinephrine administration was accentuated when removing all groups that had an error in management.”
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.