Prophylactic Measures

Abstract

Since risk patients tolerate nonionic X-ray CM and effective premedications are available, previosly frequent side effects of CM examinations, such as nausea and vomiting, now occur rarely. Moreover, patients who have not had anything to eat or drink for longer periods of time are less calm and cooperative and more susceptible to side effects during an examination. In view of this, in 1992 a German group of radiological experts took up the question of optimal patient preparation, in the interests of both physician and patient and for the safety of the latter. A survey of the participating experts showed great discrepancies in the recommended periods of abstinence from solid food and liquids prior to intraarterial, intravenous, intrathecal, and intraarticular CM administration (Fig. 5.1.1 a-d); standardization therefore seemed desirable. After intensive, as well as controversial discussions, a recommendation was made to hydrate patients adequately both before and after CM administration, i.e. to urge the patient to drink. Moreover, for the administration of nonionic X-ray CM, sufficient reasons could no longer be found for maintaining the previously held recommendation of at least a 4-h absolute abstinence from food.