This document discusses contrast media administration techniques and safety aspects. It defines contrast media as substances that increase radiographic contrast in areas where it was previously absent or low. It describes various routes of administration including enteral, parental, and topical. It provides details on intravenous, oral, rectal, intramuscular, intradermal, and other methods. It discusses equipment, potential reactions at different severity levels, and treatments for reactions like oxygen, corticosteroids, and epinephrine. It also covers patient evaluation, vital signs, premedication protocols, and the five rights of medication administration to ensure contrast media is used safely.

1. CONTRAST MEDIA
Administration Technique and
safety aspects
Ashutosh Mishra
BSc. Radiology
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2. Definition
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Contrast media is a chemical substance which when introduced
into the body will increase the radiographic contrast in an area
where it was absent or low before.

3. Route of Administration
Enteral /Gastrointestinal route
Parental route
Topical route
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4. ENTERAL ROUTES
Oral .
Inhalation .
Nasogastric .
Sublingual.
Rectal.
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5. PARENTAL ROUTES
Intravenous.
Intra-arterial.
Intramuscular.
Subcutaneous.
Intradermal.
Intraosseous.
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6. Method of Parental injection:
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7. Intravenous Administration
 Given into the veins.
 Quickest route.
 Site : median cubital vein.
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8. Cont..
 Intravenous contrast- ionic and non ionic
 Now in radiology commonly we are using non ionic
compound contrast only
 The risk of the contrast media is very less
 Examples:
- Iopamidol (Isovue)
- Iohexol (Omnipaque)
- Ioprmide ( Ultravist)
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9. Equipments
 Butterfly needle or IV catheter, needle 18-20gauge
diameter, 1.5inch in length
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10. Reactions
• Nausea, vomiting
• light headache
• Mild rash
Mild
• Pleurisy
• Urticaria
Moderate
• Renal shut down
• Cardiac, respiratory arrest
Severe
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11. Intra-arterial Administration
 Given into the arteries
 Site- Radial artery
Femoral artery
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12. Reactions
• Difficulty with breathing
• light headache
• Pain at injection site
Mild
• Feeling of warmth
• Hypertension
• Bradycardia
Moderate
• Cardiac,
• Respiratory arrest
Severe
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13. Oral administration
 Used to enhance
gastrointestinal organs and
pelvic region
 Patient should under go bowel
preparation
 Patient should be fasting
several hours before
investigation
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14. Types of oral contrast
BARIUM SULPHATE
 Commonly used oral contrast for Gastro-Intestinal
tract imaging .
 It is excreted through the rectum with the feces.
GASTROGRAFFIN
 Yellowish water based drink mixed with iodine . It
has bitter taste
MANITOL (C6H10O6)
 White powder substances , sweet in taste.
 3 table spoon of manitol in 1 liter of water for
abdomen CT scan.
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15. Reactions
• Nausea, vomiting
• headache
Mild
• Persistent vomiting
• Difficulty with breathing or
swallowing
• Perforation
Moderate
• Laryngeal edema
• Pharyngeal edema
Severe
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16. Intramuscular administration
 Given into the muscle.
 Site -Deltoid muscle of upper arm or gluteal muscle
in the hip or vastus lateralis muscle of the lateral
thigh.
 Equipment – needle 1 inch.
(22 gauge).
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17. Reactions
• Nausea, vomiting
• Headache
• Pain at injection site
Mild
• Irritation of skin
• Urticaria, fever
• Breathlessness
Moderate
• Paralysis
• Edema
Severe
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18. Intradermal administration
 Given between epidermis and dermis layer of the
skin.
 Given as a test dose to check patient sensitivity to
contrast media or a drug.
 Equipment – tuberculin syringe with 26 gauge
needle 5/8inch.
 Site – anterior forearm.
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19. Rectal administration
 Given through the Anus.
 Used to enhanced images of
large intestine.
 Administrated through enema
Eg- Barium Enema
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20. Reactions
• Nausea, vomiting
• Headache
• Cold
Mild
• Discomfort
• Abdominal pain
• Local trauma to rectum
Moderate
• Hypotension
• Edema
Severe
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21. Interosseous administration
 Synovial joint space
examination using contrast
medium.
 Commonly studied knee
and hip joint
 Occasionally the shoulder ,
temporo-mandibular joint,
wrist and elbow joint.
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22. Reactions
• Nausea
• Mild rash
Mild
• Pluritis
• Urticaria
• Breathlessness
Moderate
• Renal shut down
• Cardiac arrest
Severe
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23. Safety
Aspects:
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24. PATIENT EVALUATION
 Patient history
Patient name
Age, gender
Past/Present history
 Lab report
Blood urea(8-35 mg/dl)
Serum creatine level (0.6-1.6 mg/dl)
Serum potassium level (135-145 mmol/l)
Blood report
 Medications – currently / recently used
 Pregnancy
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25. VITAL SIGNS
 Body temperature
 Blood pressure
 Heart rate(pulse rate)
 Respiratory rate
 O2 saturation
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26. PREMEDICATION PROTOCOL FOR ALLERGIC PATIENTS:
PREDNIOSOLONE 50 mg ORAL. 12, 6, 1 hrs before contrast
injection.
METHYL PREDNISOLONE 32 mg ORAL. 12 and 2 hrs
before contrast injection.
AT THE TIME OF CONTRAST INJECTION:
HYDROCORTISONE 200 mg, I V, 1 hr before contrast
injection.
DIPHENHYDRAMINE 50mg,I M/ORAL, 1 hr before contrast
injection.
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27. Treatment for contrast
reactions
OXYGEN
CORTICO
STEROIDS
EPINEPH
RINE
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28. Oxygen
 Oxygen equipment
Cylinder
 Masks
Nasal canula
Simple face mask
Reserviour mask
 10-12L/min via face mask.
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29. Epinephrine
For anaphylactoid reactions.
It is a powerful sympathomimetic
agent Activates  and β adrenergic
receptors.
Dose- 0.1-0.3 ml (s.c) and 1-3ml (i.v)
Life threatening complications-
hypertensive crisis
myocardial ischeamia
infarction
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30. Corticosteroids
 Effective for late
reactions
 i.v dose of 100-1000 mg
(hydrocortisone)
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31. 5 Rights of Medication
Administration
To the right Patient
Of the right Medication
The right Dose
At the right Time
By the right Route
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32. Thank you
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