Effect of available intravenous access on accuracy and timeliness of epinephrine administration

Purpose To evaluate the effect of available intravenous (IV) access on the accuracy and timeliness of epinephrine administration during a surprise mock severe contrast reaction. Methods Informed consent was waived for this prospective randomized IRB-approved study. Radiology trainees with previous a...

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Bibliographic Details
Published in:Abdominal imaging 2016-06, Vol.41 (6), p.1133-1141
Main Authors: Masch, William R., Ellis, James H., Wang, Carolyn L., Cohan, Richard H., Davenport, Matthew S.
Format: Article
Language:English
Subjects:
Administration, Intravenous
Adrenergic alpha-Agonists - administration & dosage
Contrast Media - adverse effects
Drug Hypersensitivity - diagnosis
Drug Hypersensitivity - drug therapy
Edema - chemically induced
Education, Medical, Graduate
Epinephrine - administration & dosage
Gastroenterology
Hepatology
Humans
Imaging
Laryngeal Diseases - chemically induced
Medicine
Medicine & Public Health
Patient Simulation
Prospective Studies
Quality Improvement
Radiology
Radiology - education
Time-to-Treatment
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Summary:Purpose To evaluate the effect of available intravenous (IV) access on the accuracy and timeliness of epinephrine administration during a surprise mock severe contrast reaction. Methods Informed consent was waived for this prospective randomized IRB-approved study. Radiology trainees with previous annual hands-on contrast reaction training ( n  = 46) were randomized to one of two surprise mock contrast reactions over a 23-month period: Group 1—severe laryngeal edema with IV access present ( n  = 27) or Group 2—severe laryngeal edema without IV access present ( n  = 19). Both intramuscular (IM, Epi-Pen ® ) and IV epinephrine were available in both scenarios. Time-to-treat and epinephrine administration error rates were compared by study group and by route of administration using two-tailed Student’s t test or χ 2 test. Epinephrine administration errors were correlated with training experience using Pearson’s correlation. Results Mean time to epinephrine administration was significantly faster for scenarios without IV access (Group 2: 35 ± 16 s vs. Group 1: 62 ± 49 s, p  = 0.03), and for intramuscular administrations overall (IM: 42 ± 34 s vs. IV: 98 ± 46 s, p  
ISSN:2366-004X
2366-0058
DOI:10.1007/s00261-016-0660-8