Harbor:Creatinine screening prior to IV contrast: Difference between revisions
ClaireLewis (talk | contribs) No edit summary |
|||
| Line 4: | Line 4: | ||
==Guideline== | ==Guideline== | ||
* [https://lacounty-my.sharepoint.com/personal/jshim_dhs_lacounty_gov/_layouts/15/onedrive.aspx?FolderCTID=0x01200042EAB0B5A27C63468CDB5666D0718199&id=%2Fpersonal%2Fjshim%5Fdhs%5Flacounty%5Fgov%2FDocuments%2FMicrosoft%20Teams%20Chat%20Files%2FUse%20of%20IV%2 DHS IV Contrast Expected Practices 10-2022] | |||
** No need for screening | |||
*** GFR>30 | |||
ED patients do NOT require creatinine measurement prior to IV contrast: | ED patients do NOT require creatinine measurement prior to IV contrast: | ||
*If the study is immediately necessary to prevent life-threatening decompensation or delay in emergent treatment (e.g. trauma patients) | *If the study is immediately necessary to prevent life-threatening decompensation or delay in emergent treatment (e.g. trauma patients) | ||
*If they do not meet any of the following criteria<ref>Tippins RB, Torres WE, Baumgartner BR, Baumgarten DA. Are screening serum creatinine levels necessary prior to outpatient CT examinations? Radiology. 2000 Aug;216(2):481-4.</ref><ref>ACR Manual on Contrast Media – Version 10, 2015. [http://www.acr.org/~/media/ACR/Documents/PDF/QualitySafety/Resources/Contrast%20Manual/2015_Contrast_Media.pdf PDF] Accessed 08/10/15</ref>: | *If they do not meet any of the following criteria<ref>Tippins RB, Torres WE, Baumgartner BR, Baumgarten DA. Are screening serum creatinine levels necessary prior to outpatient CT examinations? Radiology. 2000 Aug;216(2):481-4.</ref><ref>ACR Manual on Contrast Media – Version 10, 2015. [http://www.acr.org/~/media/ACR/Documents/PDF/QualitySafety/Resources/Contrast%20Manual/2015_Contrast_Media.pdf PDF] Accessed 08/10/15</ref>: | ||
Revision as of 17:56, 20 March 2023
Background
- It may be possible to reduce the use of creatinine screening in ED patients requiring IV contrast for CT or other radiographic evaluation
- Data is sparse, however, and any guidelines should be utilized with that in mind, and in the context of local policies.
Guideline
- DHS IV Contrast Expected Practices 10-2022
- No need for screening
- GFR>30
- No need for screening
ED patients do NOT require creatinine measurement prior to IV contrast:
- If the study is immediately necessary to prevent life-threatening decompensation or delay in emergent treatment (e.g. trauma patients)
- If they do not meet any of the following criteria[1][2]:
- Age >60
- History of kidney disease
- Kidney transplant
- Dialysis
- Single kidney
- Renal cancer
- Kidney surgery
- Family history of kidney failure
- Diabetes
- Hypertension
- Collagen vascular disease (e.g. SLE, scleroderma, rheumatoid arthritis)
- Paraproteinemia (e.g. multiple myeloma)
- Recent use of nephrotoxic medication (eg, metformin, aminoglycosides)