Department of Radiology
Contrast Media Policy
The aim of this policy is to support the following reference documents with local information:
1. Standards for Iodinated Intravascular Contrast Agent Administration to Adult Patients (RCR 2005)
2. Advice on the Management of Reactions to Intravenous Contrast Media (RCR 1996)
3. Gadolinium Based Contrast Media and Nephrogenic Systemic Fibrosis (RCR 2007)
Contrast media is used to enhance diagnostic imaging:
· In accordance with Radiology Directorate imaging protocols.
· As authorised by a Consultant Radiologist.
Appendix 1 lists the contrast media currently utilised by the department.
Contrast media will be administered by:
· A qualified Radiographer.
· A Consultant Radiologist.
· A radiology Nurse.
· A registered healthcare professional under the supervision of an HPC registered Radiographer or Consultant Radiologist eg Surgeon, Anaesthetist, Speech Therapist.
Please see also:
o BHT Radiology Department Contrast Media Injection Policy.
o BHT Radiology Intravenous Injection Training – Guide.
o BHT IV Medicines Policy.
Supplementary Medicines
Many examinations (for example: Barium Enema, Barium Follow-through, CT Pneumocolon, MAG3 Renogram) necessitate the administration of supplementary drugs to achieve optimum image quality. These drugs should only be given according to agreed imaging protocols and under the authorisation of a Consultant Radiologist.
Please see documentation specific to individual supplementary medicines. For example:
o Buscopan Policy.
o Nuclear Medicine Department - Intravenous Injection of Frusemide 40mg.
o Guidelines for Urology Imaging - Appendix 1 Intravenous Injection of Furosemide for the Purpose of CT Urogram.
o Metaclopromide Protocol
Storage of Contrast Media
Contrast media are prescription only drugs and as such must be stored securely. Please see:
o Care and Control of Medicines Policy – Medicines Held on Wards and in Departments – X-ray Department.
Safety Precautions
A medical doctor should be immediately available within the department to deal with any adverse reaction.
Prior to administration of any contrast media the patient should be questioned to establish:
· Contraindications – eg allergies, possible GI tract perforation
See relevant imaging protocols or information specific to relevant contrast agent.
· Conflict with other prescribed medication – eg Metformin
Please see Metformin policy.
· Particular precautions are needed with the use of high pressure injectors.
Please see Administration of Intravenous Medicines in Radiology Policy and local imaging protocols
HJR 12.08.08
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Appendix 1
Contrast Media currently used within BHT Radiology (2008)
Name / Route / Typical useBaritop 100 / Barium Sulphate / Oral / Barium swallow, small bowel meal
Biliscopin 50 / Oral / cholecystogram
Carbex Granules / Oral / Double contrast barium meal
Carbon Dioxide / PR / Double contrast barium enema, pneumocolon
Conray 280 / Iothalamic Acid / Intrathecal / Myelogram
Dotarem / Gadoteric Acid / IV / MRI
E Z HD / Barium Sulphate Ph Eur 98%w/w / Oral / Barium meal
Gastromiro / Iopamidol / Oral / CT, Water-soluble swallow
Lipiodol / Sialography
Magnevist / Dimeglumine Gadopentate / IV / MRI
Magnevist 2mmol/l / Dimeglumine Gadopentate / Intra-articular / MRI arthrogram
Niopam, 200 / Iopamidol / IV, intracavity / Sinogram, myelogram, cavity filling,
Niopam 300 / Iopamidol / IV, Intraarticular intracavity, Intrathecal / Hysterosalpinography, joint injection, discogram, arthrogram, sialogram, dacrocystogram, sinogram, myelogram, cavity filling, assessment of fine bore NG tube
Polibar / Barium Sulphate Ph Eur 94%w/w / PR / Barium enema
Ultravist 240 / Iopromide / IV / Paediatric CT
Ultravist 300 / Iopromide / IV, Via urinary catheter, intracavity / IVUs, CT vascularwork, nephrostomy, sinogram
Urografin 150 / Via urinary catheter, PR / Cystrogram, water soluble enema
Vasovist / IV / MRI
Visipaque 270 / Iodixanol / IV / As per ultravist 300 for patients with high creatinine and low GFR
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