Patient needs a CT angio but is allergic to Iodine

roser13, ASN, RN · Jun 3, 2009

To reduce a potential allergic reaction...

Cassaundra · Jun 3, 2009

If I recall correctly, Prednisone is a steroid that will help keep the inflamation down and her airway open long enough to intubate should she go into anaphlaxis.

Virgo_RN, BSN, RN · Jun 3, 2009

My patient is schedulled for a CT Angio tomorrow. She is allergic to Iodine (Contrast dye ) so they started her on predinisone and benadril. Can anybody tell me why Prednisone was ordered?

To reduce the inflammation associated with an allergic reaction.

Roy Fokker, BSN, RN · Jun 3, 2009

The standard "cocktail" in the ED is Benadryl, Prednisone (sometimes Cortisol) and Pepcid.

cheers,

theophania_jean · Jun 3, 2009

pardon the ignorance, but it is 100% required to have contrast with the angio.

We've never really had this issue with Renal Patients that have a high creatin. -usually they just don't have the Contrast.

nerdtonurse?, BSN, RN · Jun 3, 2009

When I've had those, I go ahead and pull a vial of benedryl out of the dibold, and have it in the patient's room until I'm sure they're okay when they come back. Last thing you want is to need it, and the dibold/pyxis decides to lock up.

helpnurse · Jun 4, 2009

Wow, thanks for the fast response....Appreciate it

zamboni · Jun 4, 2009

We have a prep protocol for allergic pts that need contrast...even for "urgent" but not "now" situations. It involves multi doses of Benadryl and SoluMedrol over a period of (I think) 8 hours. For the life of me, I can't remember the doses or time increments right now...but the theory is to really knock down the inflammatory response in over time, in phases.

God, I'm so brain dead right now. I had to do it just a few weeks ago for a patient...I really should remember it. But I do know that it worked very well for a highly allergic patient, and he had zero reaction to the contrast.

Maybe I'll have more synapses firing here in a few when I wake up...

ohmeowzer RN, RN · Jun 4, 2009

our protocol is 16 hours before MRI 50mg benedryl and 50mg prednisone, then 12 hours repeat , then 6 hours before repeat prednsione and benedryl , then right before procedure repeat again...