Contrast Media Reactions, Pharmacology, and Emergency Response in Radiography

What are the expected side effects of contrast media?

Warmth, metallic taste, nausea.

What are mild reactions to contrast media?

Itching, sneezing, hives, limited urticaria.

What are moderate reactions to contrast media?

Larger hives, bronchospasm, wheezing, facial/laryngeal edema.

What are severe reactions to contrast media?

Hypotension, tachycardia, respiratory distress, laryngeal edema, arrhythmias, cardiac arrest.

What is a vasovagal response?

Bradycardia, hypotension, faintness.

What should be done if a patient has a reaction to contrast media?

Stop contrast injection, monitor airway, call for emergency assistance, administer emergency drugs, document reaction.

What is the chemical name of a drug?

Describes the drug's molecular structure.

What is a generic name of a drug?

Assigned when the drug is approved; universally used (e.g., ibuprofen).

What is a trade name of a drug?

Manufacturer's brand name (e.g., Advil, Motrin).

What do analgesics do?

Reduce pain.

What do sedatives/antianxiety drugs do?

Calm the patient; may cause drowsiness.

What do antihypertensives do?

Alter blood pressure.

What are radiopaque contrast agents?

Absorb x-rays; appear white; contain iodine or barium.

What are radiolucent contrast agents?

Air/gas; appear dark on images.

What are the pharmacokinetic principles of drugs?

Absorption, distribution, metabolism, excretion.

What are the pharmacodynamic principles of drugs?

Drug-receptor interactions, affinity, efficacy, agonist/antagonist actions.

What are the 5 Rights of drug administration?

Right patient, drug, amount, route, time.

What precautions should be taken during drug administration?

Check labels, monitor patients, do not recap used needles.

What is the best site for venipuncture?

Cephalic or basilic veins of the forearm.

What should be done if a patient has a head or spinal cord injury?

Do not move neck/head, maintain airway, observe for changes in LOC.

What should be done for a patient with a fracture?

Do not remove splints, support joints, move gently.

What are the responsibilities of a radiographer in the surgical suite?

Maintain strict sterile field, know sterile vs nonsterile areas.

What should you not remove from dressings?

Do not remove dressings.

What precautions should be taken in the surgical suite?

Use sterile sheets/precautions.

What should be assessed for neurologic and cognitive functioning?

Check orientation (name, date, location, reason for visit), evaluate ability to follow directions, assess vital signs, use Glasgow Coma Scale.

What are the three classifications of shock?

Hypovolemic, Cardiogenic, Distributive.

What is hypovolemic shock?

Loss of blood/fluid.

What is cardiogenic shock?

Heart cannot pump effectively.

What is distributive shock?

Pooling of blood in vessels.

What are the stages of shock?

Compensatory stage, Progressive stage, Irreversible stage.

What are the symptoms of the compensatory stage of shock?

Cold, clammy skin; nausea; increased respiratory rate; anxiety; drop in BP; increased HR.

What are the symptoms of the progressive stage of shock?

Very low BP, rapid shallow breathing, tachycardia, chest pain, organ failure symptoms.

What are the symptoms of the irreversible stage of shock?

Severe hypotension, renal/liver failure, lactic acidosis, death likely.

What defines distributive shock?

Blood pools in peripheral vessels, leading to decreased venous return.

What are the three types of distributive shock?

Neurogenic, Septic, Anaphylactic.

What is the role of the radiographer in shock response?

Recognize early symptoms, stop procedure, call for help, maintain airway, provide oxygen, keep patient warm, monitor vital signs, do not leave patient alone.

What are the clinical manifestations of pulmonary embolus?

Rapid weak pulse, dyspnea, tachypnea, hyperventilation, tachycardia, cough, hemoptysis, cyanosis, diaphoresis, syncope, sudden change in mental status, possible sudden death.

What should be done in response to a pulmonary embolus?

Stop exam, call emergency team, do not leave patient, administer oxygen, prepare for CPR if needed.

What is diabetes mellitus?

Chronic metabolic disease due to insufficient insulin or poor insulin utilization, leading to hyperglycemia.

What are the three major types of diabetes mellitus?

Type I, Type II, Gestational.

What are the symptoms of a stroke (CVA)?

Sudden headache, one-sided weakness or numbness, facial droop, eye deviation, vision loss, confusion, speech difficulty, ataxia, nausea/vomiting, loss of consciousness.

What actions should be taken for a stroke?

Call emergency immediately, stop procedure, do not leave patient, monitor vitals, prepare for oxygen and emergency response.

What are the symptoms of cardiac failure?

Loss of pulse, chest pain, cyanosis, unconsciousness.

What is the response to cardiac failure?

Begin CPR, call emergency team, use AED ASAP.

What are the symptoms of respiratory dysfunction/arrest?

Labored/noisy breathing, wheezing, accessory muscle use, cyanosis, frothy pink sputum.

What is the response to respiratory dysfunction/arrest?

Open airway, provide oxygen, prepare for CPR, call emergency team.

What are the symptoms of mechanical airway obstruction?

Sudden choking, hands to throat, inability to speak, cyanosis, panic.

What intervention should be performed for mechanical airway obstruction?

Perform abdominal thrusts (Heimlich), if unconscious perform CPR.

What actions should be taken if a patient faints?

Have patient lie down, elevate legs, do not try to hold them upright, monitor vitals.

What actions should be taken if a patient has a seizure?

Stay calm, call for help, do not put anything in mouth, protect from injury, observe time and characteristics, turn patient on side after seizure.

What is autonomy in ethical principles?

The right of individuals to make their own decisions about their care.

What is beneficence in ethical principles?

The obligation to do good and act in the patient's best interest.

What is confidentiality in ethical principles?

Keeping private information protected; only sharing on a need-to-know basis.

What is justice in ethical principles?

Fairness—patients receive equal treatment and equal distribution of benefits based on need.

What is nonmaleficence in ethical principles?

"Do no harm." Avoid causing injury or suffering.

What is paternalism in ethical principles?

Acting as a parent; overriding autonomy when necessary to prevent greater harm.

What is veracity in ethical principles?

Truthfulness and honesty.

What is the double effect in ethical principles?

An action can have both a good and a bad effect, but the intent must be good.

What is fidelity in ethical principles?

Loyalty; keeping promises, fulfilling commitments.

What is the sanctity of life in ethical principles?

Life is of the highest value; respect and preserve human life.

What is respect for property in ethical principles?

Do not damage the patient's or the facility's belongings; treat property with care.

What are ethical dilemmas in digital imaging?

Image cropping or masking, manipulation of data, repeat exposure dilemmas, maintaining confidentiality.

What is simple consent?

General permission for care; patient allows the provider to perform basic procedures.

What is implied consent?

Patient's actions indicate consent or would reasonably give consent if able.

What is expressed consent?

Clearly stated consent—can be verbal or written but does not require writing.

What is informed consent?

Patient is fully educated about risks, benefits, alternatives, and nature of the procedure.

What is the role of documentation in legal cases?

Factual account of what happened, primary communication tool, legal evidence, electronic timestamps.

What are red flags for attorneys in documentation?

Notes crossed out or corrected improperly, late entries not supported by earlier documentation, missing documentation.

Why does good documentation matter?

It protects both the patient and the technologist.