Abstract

In excess of 50 contrast-enhanced computed tomography (CT) examinations are typically undertaken in our tertiary hospital NHS Trust each weekday, approximately 13,000 each year. In the Department of Radiology alone, we inject more than 1300 l of iodinated contrast medium per annum. There is a real need to devise a policy to anticipate contrast medium-induced nephropathy (CIN) and minimize its effects, without disrupting the high-intensity CT service. Having written a comprehensive yet pragmatic policy to reduce the incidence of this iatrogenic condition, it seemed sensible to share it with the wider radiology community and share the experience and lessons learnt in engaging all the stakeholders, ushering in the change with as little fuss as possible. The ramifications on primary and secondary care had to be anticipated, resource implications managed, and staff trained. This review is therefore presented in four sections: framing the problem, assessing its size and nature; a succeeding section on the available guidelines and their uptake; the policy itself to reduce CIN in CT is presented in the third section; and crucially, a description of the policy introduction process in the last section.

Links

Publisher Full Text

Authors

Richenberg J

Institution

Radiology Department, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK. Jonathan.Richenberg@bsuh.nhs.uk

Source

Clinical radiology 67:12 2012 Dec pg 1136-45

MeSH

Clinical Protocols
Contrast Media
Great Britain
Humans
Kidney Diseases
Organizational Policy
Risk Assessment
Risk Factors
Tertiary Care Centers
Tomography, X-Ray Computed

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22717146