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Pediatric Radiology

, 38:714 | Cite as

The radiology perspective: needs and tools for management of life-threatening events

  • Ana Maria GacaEmail author
  • Catherine B. Lerner
  • Donald P. Frush
ALARA: BUILDING BRIDGES BETWEEN RADIOLOGY AND EMERGENCY MEDICINE

Abstract

Studies have shown that life-threatening contrast agent reactions in adults are very rare, and even less common in children. The rarity of severe allergic reactions to contrast material challenges educators to achieve radiology resident competency in this setting. However, using a simulated anaphylactic contrast reaction paradigm, we have drawn two conclusions: (1) Residents are insufficiently prepared to recognize and manage these life-threatening events and (2) with an interactive, computer-based tool we can significantly improve resident performance in these situations. Simulation is a growing tool in medicine and allows standardized resident exposure to uncommon events in a setting that is conducive to resident education without fear of repercussions (see Ruddy and Patterson in this issue of Pediatric Radiology). More important, simulation provides a cornerstone in patient safety resident education without putting patients at risk.

Keywords

Education Simulation Safety 

References

  1. 1.
    Kohn LT, Corrigan J, Donaldson MS (2000) To err is human: building a safer health system. National Academy, Washington, DCGoogle Scholar
  2. 2.
    Cohen KJ, Rhenman E (1961) The role of management games in education and research. Manage Sci 7:131–166Google Scholar
  3. 3.
    Bradley P (2006) The history of simulation in medical education and possible future directions. Med Educ 40:254–262PubMedCrossRefGoogle Scholar
  4. 4.
    Tjomsland N, Baskett P (2002) Asmund S. Laerdal. Resuscitation 53:115–119PubMedCrossRefGoogle Scholar
  5. 5.
    Cochran ST, Bomyea K, Sayre JW (2001) Trends in adverse events after IV administration of contrast media. AJR 176:1385–1388PubMedGoogle Scholar
  6. 6.
    Mortele KJ, Oliva MR, Ondategui S et al (2005) Universal use of nonionic iodinated contrast medium for CT: evaluation of safety in a large urban teaching hospital. AJR 184:31–34Google Scholar
  7. 7.
    Cohen MD, Smith JA (1994) Intravenous use of ionic and nonionic contrast agents in children. Radiology 191:793–794PubMedGoogle Scholar
  8. 8.
    Dillman JR, Strouse PJ, Ellis JH et al (2007) Incidence and severity of acute allergic-like reactions to IV nonionic iodinated contrast material in children. AJR 188:1643–1647PubMedCrossRefGoogle Scholar
  9. 9.
    American Academy of Pediatrics (2002) Pediatric advanced life support manual. American Heart Association, Dallas, TX, pp 1–39Google Scholar
  10. 10.
    Shah AN, Frush K, Luo X et al (2003) Effect of an intervention standardization system on pediatric dosing and equipment size determination: a crossover trial involving simulated resuscitation events. Arch Pediatr Adolesc Med 157:229–236PubMedGoogle Scholar
  11. 11.
    Deboer S, Seaver M, Broselow J (2005) Color coding to reduce errors. Am J Nurs 105:68–71PubMedGoogle Scholar
  12. 12.
    Gaca AM, Frush DP, Hohenhaus SM et al (2007) Enhancing pediatric safety: using simulation to assess radiology resident preparedness for anaphylaxis from intravenous contrast media. Radiology 245:236–244PubMedCrossRefGoogle Scholar
  13. 13.
    American Heart Association (2002) Pediatric advanced life support manual. American Heart Association, Dallas, TXGoogle Scholar
  14. 14.
    Grant EC, Marczinski CA, Menon K (2007) Using pediatric advanced life support in pediatric residency training: does the curriculum need resuscitation? Pediatr Crit Care Med 8:433–439PubMedCrossRefGoogle Scholar
  15. 15.
    Perkins GD (2007) Simulation in resuscitation training. Resuscitation 73:202–211PubMedCrossRefGoogle Scholar
  16. 16.
    Yamamoto LG, Wiebe RA (1989) Pediatric and adult emergency management assistance using computerized guidelines. Am J Emerg Med 7:91–96PubMedCrossRefGoogle Scholar
  17. 17.
    Bordley WC, Travers D, Scanlon P et al (2003) Office preparedness for pediatric emergencies: a randomized, controlled trial of an office-based training program. Pediatrics 112:291–295PubMedCrossRefGoogle Scholar
  18. 18.
    Frush K (2007) Preparation for emergencies in the offices of pediatricians and pediatric primary care providers. Pediatrics 120:200–212PubMedCrossRefGoogle Scholar
  19. 19.
    Klig JE, O'Malley PJ (2007) Pediatric office emergencies. Curr Opin Pediatr 19:591–596PubMedCrossRefGoogle Scholar
  20. 20.
    Becker GJ (2007) Simulation and the coming transformation of medical education and training. Radiology 245:7PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Ana Maria Gaca
    • 1
    Email author
  • Catherine B. Lerner
    • 1
  • Donald P. Frush
    • 1
  1. 1.Department of RadiologyDuke University Medical CenterDurhamUSA

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