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Premedicating patients with contrast allergies?????



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Feb 22, 2006 08:31 PM

Premedicating patients with contrast allergies?????


When patients have contrast allergies, our Radiologists prefer oral preps. It is a 13 hour prep. We have standing orders for inpatients. How do other hospitals prep their outpatients? At present, our outpatients come in the day before, and our CT techs hand out the prep (which is ordered by our MD Director). We need to find a better solution, since techs really are not allowed to dispense medications. We have 2 FT RNs and 1 PT. RN hours are 0630 to 1500. Any suggestions?


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10 Comments
No. 1
from dianah
Old Feb 22, 2006, 11:51 PM

Default Re: Premedicating patients with contrast allergies?????
We nurses prepared the prescriptions (had a stamp for each), and had the Radiologists sign them (or we phoned them in), and instructed the patients on taking them. It worked for us; not in our scope of practice to dispense meds themselves, but yes to the scrips (they could be picked up at the patient's convenience, as long as they could get them filled and taken in time for the exam).
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No. 2
from hawks5
Old Feb 23, 2006, 09:52 PM

Default Re: Premedicating patients with contrast allergies?????
We also created pre-printed scripts that can be called into a pharmacy or handed out at the front desk- (prednisone and benadryl).
Another option is a quick prep (set of pre-printed orders) we do for add-on cases etc. with IV methyl-prednisone, benadryl, and pepcid. Our radiologists have been great about signing orders/scripts.
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No. 3
from mawlvn
Old Aug 19, 2006, 02:25 PM

Default Re: Premedicating patients with contrast allergies?????
Our outpatient DI department also has pre printed script signed by the radiologist that can be filled at our pharmacy. Add ons are only given IV benadryl pre and post.
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No. 4
from vandebar
Old Mar 05, 2007, 10:44 AM

Default Re: Premedicating patients with contrast allergies?????
Our patients identified with a contrast allergy during the phone triage process get tagged for a plan of care for contrast allergies and standing orders are followed. This includes prednisone 60mg po the night prior to the procedure and repeated the morning of the procedure. Also benadryl 25 mg po the night before the procedure and 25mg po benadryl repeated one hour prior to the procedure. Please note that this is a cardiologist standing order. These patients will receive on arrival Solumedrol 125mg IVP prior to the procedure. Any patient having any kind of reaction to iodine, (including seafood) will be given the above order by the cardiologist. NOW whats INTERESTING is that our radiologist use a completely different standing order which is the prednisone 13 - 7 - 1 hour prior to procedure, an H2 blocker. Any patient having a rash or hives would receive that order. For our radiologist, patients who experienced a reaction that included SOB, swelling, edema, bronchospasm...etc... then the 13-7-1 PLUS H2 blocker, plus an IV steroid. The oral prep is called into the patients pharmacy by the triage nurse. A standing order is flagged in the chart for the radiology nurse.
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No. 5
from zena231
Old Mar 05, 2007, 10:53 AM

Default Re: Premedicating patients with contrast allergies?????
I schedule outpatient radiology procedures and we have the rad techs tell the scheduling dr's office the prep and they are responsible for giving a script and the medication info to the patient.
Our prep orders are:
13 hours before appt(scan time)
50 mg prednisone

7 hrs before
50 mg prednisone

1 hr before appt
50 mg prednisone and
50 mg benedryl
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No. 6
Old May 27, 2007, 10:01 PM

Default Re: Premedicating patients with contrast allergies?????
I work in a free-standing outpatient medical imaging center. If a patient requires premedication for a contrast allergy we give them pre-printed prescriptions and re-schedule their test at the hospital next door.
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No. 7
Old Jan 24, 2009, 01:29 PM

Default Re: Premedicating patients with contrast allergies?????
Originally Posted by Lori Ann View Post
When patients have contrast allergies, our Radiologists prefer oral preps. It is a 13 hour prep. We have standing orders for inpatients. How do other hospitals prep their outpatients? At present, our outpatients come in the day before, and our CT techs hand out the prep (which is ordered by our MD Director). We need to find a better solution, since techs really are not allowed to dispense medications. We have 2 FT RNs and 1 PT. RN hours are 0630 to 1500. Any suggestions?
What medication(s) are in the "prep"?
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No. 8
Old Jan 24, 2009, 01:31 PM

Default Re: Premedicating patients with contrast allergies?????
Originally Posted by DutchgirlRN View Post
I work in a free-standing outpatient medical imaging center. If a patient requires premedication for a contrast allergy we give them pre-printed prescriptions and re-schedule their test at the hospital next door.
Please tell me what is on the prescription and if you know, how the patients do with the contrast after taking it.
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No. 9
from 5780
Old May 16, 2009, 09:22 PM

Default Re: Premedicating patients with contrast allergies?????
To lamazeteacher - there is obviously a variety of approaches. I certainly have had patients with contrast allergies who do just fine with only a prednisone prep (the man I'm thinking of has had two fistulograms in the last six weeks). It is up to the ordering physician to order the prep as well, but the techs in our department usually call the nurse if they have a patient with an allergy, even if the patient has been prepped. I don't know if there is any standard prep for contrast allergies. This now gives me something new to learn! (I love my job!)
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