Some hazards apply to multiple imaging procedures; some apply very specifically to a particular procedure.
Injection of Contrast Media into the patient
The major hazard in most imaging is due to intravenous use of contrast media which can produce reactions ranging from pain and hematoma to kidney damage, to infection and thrombosis at the site of the injection. All injected chemicals can also produce adverse reactions due to physiological or pharmacological effects. Potentially, organ damage can occur in endoluminal imaging procedures such as endosonography.
Improperly administered medications in radiological setting
Problems include erroneous switching of infusion rates for IV medications following procedures or incorrect programming and operation of IV pumps; and improper dosing of sedating medications, among others. Another major cause of errors is overlooking the growing number of drugs in certain classes, known as “offenders,” that can interact with contrast agents—such as diabetes drugs.
Claustrophobic stress in CT and Nuclear, and MR imaging
Claustrophobia is (rarely) observed in patients undergoing CT and nuclear imaging procedures, but relatively common in MR imaging, where up to 2% of the examined patients will refuse examination.
Over dose of ionizing radiation
While every x-ray examination will subject patients to some amount of radiation, the ones mostly likely to subject your patient to a high dose of radiation are:
- Computed tomography (CT), especially of the abdomen and pelvis with and without contrast;
- Interventional fluoroscopic examinations, especially complicated cardiac and neurological procedures; and
- Some nuclear medicine examinations, such as stress cardiac studies.
Magnetic fields created during MRI
The powerful magnetic field of the MR system will attract iron-containing objects and may cause them to move suddenly and with great force. This can pose a possible risk to the patient or anyone in an object’s “flight path.” The powerful magnetic field of the MR system will pull on any iron-containing object in the body, such as certain medication pumps or aneurysm clips or other metal in the body.
Misinterpretation of results; failure to get expert second opinion
Failure to properly interpret radiographs and communicate the interpretations in a timely accurate fashion. Failure to document discrepancies in interpretation. Making quick diagnoses that cause radiologists to overlook critical information and increase the likelihood of errors. Failure to document and retain second opinions. Failure to immediately repeat process if radiographs are of poor quality.
By: Brad Hatfield, Vice President – Program Underwriting & Risk Management
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