Adjuncts to radiography

The most serious adverse reaction to contrast agents is anaphylactic shock, which must be treated as an emergency. See Chapter 3 for details of allergic reactions to drugs. In this type of hypersensitivity reaction, the contrast agent causes the release of histamine from mast cells and basophils. 

Less serious reactions to contrast agents are nausea and vomiting, mild skin reactions (hives) and more serious generalized skin reactions with urticaria. Nausea and vomiting rarely require treatment with antiemetics, for example domperidone. Skin reactions can be treated with oral or intravenous antihistamines, which also have an antiemetic effect. Intravenous corticosteroids may be required for serious urticaria. 

A number of drugs are used as adjuncts to radiography. They can be administered by qualified, registered and trained radiographers under patient group directions. 

See Chapter 14 for the legislation surrounding administration of drugs by members of the health care professions. 

Analgesia may be necessary for the after-effects of venepuncture or following therapeutic radiographic procedures. Peripherally acting analgesics, for example paracetamol, aspirin or ibuprofen should be sufficient. For pain that is more severe codeine may be necessary. See Chapter 12. 

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CH13 CONTRAST AGENTS AND ADJUNCTS TO RADIOGRAPHY Table 13.5 Miscellaneous adjuncts to radiography... 

Miscellaneous drugs used as adjuncts to radiography are summarized in Table 13.5. 

Adjuncts to radiography include peripherally acting analgesics and possibly codeine for pain after injection or other procedures and topical anaesthetics prior to injection. 

Explain the actions and uses of Buscopan, glucagon, metoclopramide and loperamide as adjuncts to radiography. 

I Unlabeled Uses Adjunct to bowel radiography and gastroscopy I Contraindications None known... 

Adjuncts to therapeutic radiography, used under patient group directions, include analgesics, laxatives, anti-diarrhoeals, antiemetics and drugs for wound care and skin reactions. 

Fractures in the region of the elbow can be particularly difficult to diagnose and delineate accurately. Ultrasound has been shown to be a useful adjunct to plain radiography, particularly if clinical suspicion is high and radiographs are indeterminate (Davidson et al. 1994 Markowitz et al. 1992 Vocke-Hell and Schmid 2001). With supracondylar fractures of the humerus, ultrasound may demonstrate the fracture line in association with a joint effusion and elevation of the fat pads (Figs. 4.5,4.6). 

Adjuncts used in addition to contrast agents in diagnostic radiography, under patient group directions, include laxatives, drugs to relax the bowel, normal saline and topical anaesthesia. 

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