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JRCERT Update

Adverse Reactions to Contrast: A Review

Jason W Stephenson, MD

he Joint Review Committee on Education in ƒ intravenous (IV)
Radiologic Technology (JRCERT) requires all ƒ intra-articular
accredited programs to follow an approved cur- ƒ intrathecal
Triculum, as defined in Standard 3, Objective 3.2: ƒ oral
ƒ rectal
the latest American Society of Radiologic ƒ intravesicular
Technologists [ASRT] professional curriculum Rates of adverse responses are related to the
and/or another professional curriculum adopted serum concentration of the contrast material; thus,
by the JRCERT Board of Directors following the IV route of administration is more likely to elicit
review and recommendation by the JRCERT such a response than are other types. Frequently
2,3
Standards Committee. 1 administered contrast types include iodinated and
Adverse reactions to contrast media used in medi- gadolinium-based contrast agents.
cal imaging are worthy of attention from health care
providers and educators, particularly those who Iodinated Contrast
instruct students who will administer or oversee the Iodinated contrast media are the most commonly
administration of these substances. Because health care administered agents because of their efficacy in dem-
professionals play a key role in the initial management onstrating pathology on computed tomography and
of a patient who experiences an adverse reaction to conventional radiography. The iodinated contrast agents
contrast media, they must be aware of common reac- originally used were ionic, monomeric, and they consisted
tions as well as their treatments. Curricula that include of small, ionized, inorganic, molecules bound to an iodine
4
education about adverse reactions to contrast media are atom. These older ionic small molecules (high-osmolar)
in keeping with the shared safety goals of the JRCERT were more likely to cause adverse reactions; therefore,
and ASRT. they seldom are used today. Adverse reactions caused by
the use of iodinated contrast media include :
3,5
Contrast Media ƒ nausea and vomiting
Contrast media includes any substance adminis- ƒ vasovagal responses (lightheadedness, fainting)
tered to a patient to modify the appearance of human ƒ anaphylactic reactions
tissues in images. Contrast can be administered via a ƒ anaphylaxis
variety of routes: ƒ bronchospasm

RADIOLOGIC TECHNOLOGY, July/August 2018, Volume 89, Number 6 601
Reprinted with permission from the American Society of Radiologic Technologists for educational purposes. ©2019. All rights reserved.