Medical Emergencies in the X-ray Department: Prevention and Treatment

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Abstract
Serious emergencies are fortunately rare in routine radiological practice and, consequently, the individual radiologist may gain little personal experience in dealing with them. However, with the increasing complexity of radiological procedures, these emergencies are likely to become more frequent. They may arise suddenly and proceed to a rapidly fatal termination if inadequately treated. It is therefore essential that every radiological department should be organised to deal with any emergency immediately it arises. In this paper, we discuss the general principles upon which treatment may be based. The emergency may occur following the use of contrast materials or local anaesthetics, or from various other causes, but the treatment will to some extent overlap and it must be directed, in the first instance, to the correction of whichever symptom or symptoms are endangering life. Table I presents a classification of the major complications which may be encountered together with brief notes on their treatment. The two most urgent complications are “cardiac arrest” and “respiratory failure”. Cardiac arrest may be the end result of any of the other complications or it may occur completely without warning in any patient in the department, perhaps after a coronary infarction or Stokes-Adams attack, or even following syncope in elderly, debilitated, or post-operative patients. If a successful outcome is to be accomplished, there must be no hesitation in diagnosis.