Knowledge And Practices Among, Radiologists, Radiology Residents And Radiographers In Management Of Cardiopulmonary Arrest And Anaphylactic Reactions In Radiology Department

Abstract

Emergencies in the radiology department are uncommon. They may arise in critically ill patients who are brought to the department for imaging, interventional procedures or as a result of adverse reactions to contrast media used for imaging. Adverse reactions to contrast media are infrequent and likely related to pre existing conditions. They range from very minor to severe life threatening effects and therefore initial prompt management decreases the chances of complications. Consultant radiologists, residents and radiographers must possess knowledge of the management of anaphylactic/ anaphylactoid contrast reactions and cardiopulmonary arrest (CPA) as they are likely to be the first responders in case they occur. Previous studies have shown that many radiologists lack knowledge of the management of acute contrast reactions and cardiopulmonary arrest and several institutions have instilled training programs to help their staff keep abreast with the knowledge. No similar study has been done to determine such knowledge in this country. Objective The aim of this study was to determine the knowledge and practice of radiologists, radiology residents and radiographers in the radiology departments of University of Nairobi and Kenyatta National Hospital with regard to management of cardiopulmonary arrest and anaphylactic reactions. Material and Methods A cross sectional study was conducted among 80 radiologists, radiology residents and radiographers in the radiology departments of University of Nairobi and Kenyatta National Hospital between March 2016 and August 2016. Simple random sampling was used to select the participants and questionnaires assessing the knowledge and practice were administered. Data analysis was performed using the statistical package for social studies version 20.0 xviii Results A total of 80 participants were enrolled. This included radiology consultants (n = 18), radiology residents (n = 39) and radiographers (n = 23). Most of the respondents demonstrated inadequate knowledge on the fundamental and critical components of basic life support and advanced cardiac life support. None of them answered all the questions correctly, only 55% of radiology consultants, 35% of residents and 39% of radiographers scoring above 50%. Majority (82%) of the respondents had adequate knowledge on the symptoms, signs and risk factors of adverse reactions to contrast media. However only 24% knew that intravenous epinephrine is the recommended drug for severe anaphylactic reaction. There was an association between the cadre of the respondents and their knowledge (p<0.001) on contrast reactions, however no such association was noted in CPR knowledge. Shortcomings in terms of adequate training were accentuated in this study with majority of the respondents having not attended any life support course in the last 5 years. Conclusion The health providers within the radiology unit had knowledge on identifying both mild and severe symptoms of anaphylactic reactions to contrast media. There were however knowledge gaps on management of such reactions. They also demonstrated inadequate knowledge of the fundamental and critical components of basic life support and advanced cardiac life support. Study findings highlight the need to focus on improving provider knowledge and awareness of evidence based recommendations contained in clinical guidelines. There is need for an extensive study covering more health facilities in the country. This will lead to focused continued medical education in life support and contrast anaphylaxis management.