Recognition and Treatment of Acute Contrast Reactions (Report‪)‬

About 3% of patients who receive nonionic, lower-osmolality monomeric contrast media (LOCM) will experience a contrast reaction, though the vast majority of reactions are mild and require no treatment. However, about 1 in 1600 (0.06%) of patients receiving LOCM will need treatment for a reaction and a severe life-threatening reaction occurs with about 1 in 2500 patient injections (0.04%). Key to treating a contrast reaction is recognition of the type of reaction. Patient manifestations of reactions can be generally divided into 3 main categories: the uncomfortable patient; the subdued, poorly responsive patient; and, the anxious and agitated patient. In general, the more quickly a contrast reaction is recognized, correctly diagnosed and treated, the better the result--with less medication. Therefore, the goals of management should include early detection, the necessary multitasking to understand the type of reaction, and initiation of appropriate treatment as soon as possible. This article reviews some mechanisms of reactions, the clinical presentations of the various reactions, and outlines an approach and recommended medications for dealing specifically with each reaction type.