Study of patients with intravenous contrast extravasation on CT studies, with radiology staff and ward staff cannulations

Abstract

Intravenous (IV) contrast extravasation is an adverse outcome of computed tomography (CT) studies. This study evaluates for any differences in rates of extravasation between radiology (radiographer) staff and ward medical staff cannulations, and secondarily by cannula size and study type. A prospective study of 26,854 studies in adults between September 2004 and April 2008 accumulated 119 extravasations. Patients were divided into two groups, those cannulated by radiology staff and those cannulated by non-radiology staff. Patients with extravasations were followed for treatment outcomes. Statistical analysis between our groups was undertaken. The total extravasation rate was 0.44%. The extravasation rate for those patients cannulated by radiology staff was 0.34% (n= 11,470 cannulations) and those cannulated by non-radiology staff was 0.52% (n = 15,384 cannulations). This was not statistically significantly different. The site where most extravasations occurred was at the elbow (71.4%). The injection rate where most extravasations occurred was in the 1-2 mL/s range (42%). No patient required surgical intervention or had any significant morbidity. Radiology radiographer staff can provide safe administration of IV contrast in CT scanning with low rates of extravasation. Extravasation may occur with high or low injection rates and when small or large size cannulas are used.