Impact of a Novel Radiocontrast Media Reaction Treatment Algorithm in Simulation Settings of Anaphylaxis
Saturday, March 3, 2018
South Hall A2 (Convention Center)
Iris M. Otani, MD, Alexi Otrakji, Niki Holtzman, Matthew Iandoli, Kimberly G Blumenthal, MD MSc, Aleena Banerji, MD, Gloria Salazar
RATIONALE: Epinephrine is the first-line treatment for anaphylaxis and delays in epinephrine administration can be fatal. It is essential for providers managing radiocontrast media (RCM) reactions to recognize and treat anaphylaxis following existing evidence-based guidelines. We investigated whether immediate access to a novel treatment algorithm for adverse RCM reaction identification and management improves time to epinephrine administration in radiology mannequin-based simulation.

METHODS: Twenty-one teams (each team composed of radiology staff, residents, and technologists) participated in simulation sessions. Time from simulation start to epinephrine administration was recorded. Six teams (29%, 6/21) had access to a RCM reaction treatment algorithm created by the authors per AAAAI anaphylaxis practice parameters and American College of Radiology guidelines. Individual participants completed surveys assessing RCM reaction management knowledge before and after simulation. Participants with algorithm rated it on a Likert Scale of 1 to 6 (1 ‘not helpful at all’ to 6 ‘very helpful’) after completing simulation.

RESULTS: Teams with algorithm access had significantly decreased time to epinephrine administration (p = 0.005, mean 2.4 min, 95% CI: 2.1–2.7 min), compared to teams without access (mean 3.2 min, 95% CI: 2.8–3.7 min). RCM reaction management knowledge was unchanged by simulation, similar between participants with and without algorithm access and between staff, residents, and technicians. The treatment algorithm was rated highly (mean 5.3).

CONCLUSIONS: Utilization of a novel treatment algorithm in simulation settings of RCM anaphylaxis for radiologist providers was considered helpful and decreased time to epinephrine administration. Decreased time to administration was seen even without improvements in knowledge.