Implementation plan

Recommendation

Time frame for implementation:
<1 year,

1 to 3years or

>3 years

Expected effect on costs

Limitations for implementation

Barriers to implementation1

Actions needed for implementation2

Parties responsible for actions3

Other remarks

Consider the following treatment options for contrast extravasation:

  • Try to aspirate the extravasated contrast medium through an inserted needle
  • Mark affected area
  • Use compresses, for relieving pain at the injection site
  • Use pain killers
  • Elevate the affected extremity above the level of the heart.

1 to 3 years

None

Lack of knowledge of guideline

Lack of knowledge of guideline

Dissemination of guideline

NVvR

 

Record contrast extravasation and treatment in the patient record (volume, CM  concentration, area, clinical findings).

1-3 years

None

Lack of knowledge of guideline

Lack of knowledge of guideline

Dissemination of guideline

NVvR

 

Give the patient clear instructions when to seek additional medical care:

  • Any worsening of symptoms
  • Skin ulceration
  • Development of any neurologic or circulatory symptoms, including paraesthesia’s
  • Give the patient a patient information leaflet.

1-3 years

None

Lack of knowledge of guideline

Lack of knowledge of guideline

Dissemination of guideline

NVvR

 

For severe extravasation injury:

  • Consult a plastic surgeon
  • Notify the referring physician.

1-3 years

None

Lack of knowledge of guideline

Lack of knowledge of guideline

Dissemination of guideline

NVvR

 

1 Barriers can be found at multiple levels. They can exist at the level of the consultant, the hospital organisation, and the health care system.

2 Actions needed for implementation, but also actions to promote implementation. Think about checks during quality visits, guideline publication, information of hospital management, et cetera.

3 Who is responsible for implementation of recommendations will largely be determined by the level where the barriers are expected to be.