Contrast Emergency Management: Three Case Studies Reviewed

Iodinated contrast media or gadolinium-based contrast agents utilized during image-guided exams or procedures enhance specific tissues, organs, blood vessels, and bones. This allows for the ability to better distinguish normal versus abnormal, which aids providers in diagnosing and treating various patient conditions. The administration of iodinated contrast media or gadolinium-based contrast agents can cause allergic-like reactions that can range from mild hives to severe vascular collapse. While these reactions occur very infrequently, clinical teams need to know how to recognize and treat them appropriately following the 2024 updated guidelines set forth by the American College of Radiology. This article presents three clinical cases of patients who underwent routine imaging studies and subsequently developed a mild, moderate, or severe allergic-like reaction. Contrast emergency management is discussed, pathophysiology is reviewed, and best practices for contrast emergency management preparedness are explored.