Literature DB >> 17885191

Enhancing pediatric safety: using simulation to assess radiology resident preparedness for anaphylaxis from intravenous contrast media.

Ana Maria Gaca1, Donald P Frush, Susan M Hohenhaus, Xuemei Luo, Anjanett Ancarana, Angela Pickles, Karen S Frush.   

Abstract

PURPOSE: To prospectively develop and test a simulation model for assessing radiology resident preparedness for pediatric life-threatening events in the radiology environment.
MATERIALS AND METHODS: This study was institutional review board approved. Nineteen radiology residents (10 men, nine women; mean age, 28.5 years) participated in two simulated contrast material reaction scenarios: one with and one without resuscitation aids available. Each resident examined and managed two mannequins-simulating a 1-2-year-old patient and an 8-9-year-old patient-for type, sequence, dose, and administration route for any intervention, including administering medication, calling a code team, and providing oxygen. The time to order each intervention was documented. Resident responses (time to order intervention, appropriateness of intervention, and intervention route) were evaluated. The paired t test was used to compare the time to intervention between the resuscitation-aid-available and resuscitation-aid-not-available scenarios and between the scenario performed first and the scenario performed second. The McNemar test was performed to compare the percentage of appropriate interventions between the two resuscitation aid scenarios.
RESULTS: The average time to call the code team was shorter when no resuscitation aids were available than when resuscitation aids were available (98 vs 149 seconds, P=.08). The average times to request oxygen and epinephrine were shorter when resuscitation aids were available (40 vs 89 seconds to request oxygen, P=.016; 121 vs 163 seconds to request epinephrine, P=.21). Appropriate medication dosing was not significantly different between the two scenarios. In only five of the 38 simulated scenarios was calling the code team the first intervention. The correct sequence of interventions (calling code team, providing oxygen, and then providing epinephrine) was performed by only one resident in one scenario. Only five residents recognized that they were encountering a contrast material reaction.
CONCLUSION: Simulation training for radiology residents is valuable and suggests that resident preparedness for pediatric anaphylaxis from intravenous contrast media is insufficient. Clear step-by-step resuscitation aids are needed in the radiology environment. Copyright (c) RSNA, 2007.

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Year:  2007        PMID: 17885191     DOI: 10.1148/radiol.2451061381

Source DB:  PubMed          Journal:  Radiology        ISSN: 0033-8419            Impact factor:   11.105


  11 in total

1.  Enhancing pediatric safety: assessing and improving resident competency in life-threatening events with a computer-based interactive resuscitation tool.

Authors:  Catherine Lerner; Ana M Gaca; Donald P Frush; Sue Hohenhaus; Anjanette Ancarana; Terry A Seelinger; Karen Frush
Journal:  Pediatr Radiol       Date:  2009-05-13

Review 2.  Pediatric abdominal CT angiography.

Authors:  Donald P Frush
Journal:  Pediatr Radiol       Date:  2008-05

3.  Upper gastrointestinal fluoroscopic simulator for neonates with bilious emesis.

Authors:  Ellen C Benya; Mary R Wyers; Ellen K O'Brien; Vikram Nandhan; Mark D Adler
Journal:  Pediatr Radiol       Date:  2015-03-22

4.  Teaching management of contrast reactions: does it work and how often do we need to refresh?

Authors:  Andrew T Trout; Richard H Cohan; James H Ellis; Shokoufeh Khalatbari
Journal:  Acad Radiol       Date:  2012-04       Impact factor: 3.173

5.  Evaluation of a pediatric fluoroscopy training module to improve performance of upper gastrointestinal procedures in neonates with bilious emesis.

Authors:  Ellen C Benya; Mary R Wyers; Ellen K O'Brien
Journal:  Pediatr Radiol       Date:  2016-08-25

6.  Contrast media use in radiation oncology: a prospective, controlled educational intervention study with retrospective analysis of patient outcomes.

Authors:  Christopher A Barker; Robert W Mutter; Lauren Q Shapiro; Zhigang Zhang; Suzanne L Wolden; Joachim Yahalom
Journal:  J Am Coll Radiol       Date:  2010-12       Impact factor: 5.532

7.  Simulation-based evaluation of anaesthesia residents: optimising resource use in a competency-based assessment framework.

Authors:  Melinda Fleming; Michael McMullen; Theresa Beesley; Rylan Egan; Sean Field
Journal:  BMJ Simul Technol Enhanc Learn       Date:  2020-11-01

8.  Implementation of a competency check-off in diagnostic fluoroscopy for radiology trainees: impact on reducing radiation for three common fluoroscopic exams in children.

Authors:  Sweta Shah; Stephane L Desouches; Lisa H Lowe; Nima Kasraie; Brenton Reading
Journal:  Pediatr Radiol       Date:  2014-07-24

9.  A systematic review of the incidence of hypersensitivity reactions and post-contrast acute kidney injury after ioversol in more than 57,000 patients: part 1-intravenous administration.

Authors:  Aart J van der Molen; Ilona A Dekkers; Ibrahim Bedioune; Elisabeth Darmon-Kern
Journal:  Eur Radiol       Date:  2022-03-21       Impact factor: 7.034

10.  Computer-based simulation training in emergency medicine designed in the light of malpractice cases.

Authors:  Akan Karakuş; Latif Duran; Yücel Yavuz; Levent Altintop; Fatih Calişkan
Journal:  BMC Med Educ       Date:  2014-07-27       Impact factor: 2.463

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