Tx of symptomatic urticaria (hives)
PO, IM or IV Benadryl 25-50mg
or PO Allegra (Fexofenadine) 180mg
Tx for anaphylactic shock at administration of CT contrast?
IV epinephrine 1:10,000
0.1 mg = 1 mL
up to 1 mg = 10 mL
principles of professionalism
1) primary of patient welfare
2) patient autonomy
3) social justice.
What are the two dimensions of quality?
Excellence and consistency
The two Gad contrast agents used at UMC are:
Gadobutrol (Gadavist) - Macro
Gadoxetato (Eovist) - Linear ( 50% Hepatobili excretion)
According to the publication, “To Err is Human: Building a Safer Health System”, how many in-hospital deaths are attributed to medical errors each year?
44,000-98,000
Max gray value luminance for nonmammographic interpretation should be at least __
350 cd/m2
The four elements of medical malpractice:
1) established duty of the physician to the patient
2) breach of that duty
3) causation
4) damages.
MC claims for radiologic negligence
1) diagnostic errors (MC)
2) procedural complications
3) communication deficiencies
The 6 goals of healthcare according to the IOM “Chasm” report:
safe, effective, patient-centered, timely, efficient, and equitable.
measuring and testing elements of performance to ensure standards are met and correcting instance of poor quality
Quality control
process for monitoring and ensuring performance quality in an organization
Quality Assurance
activities designed to improve performance quality in an organization in a systematic and sustainable way.
Quality improvement
Three elements of anticipation by HRO (High reliability organizations)
- preoccupation with failure
- reluctance to simplify
- sensitivity to operations
According to the Agency for Healthcare Research and Quality what commitment includes a “blame-free environment where individuals are able to report errors or near misses without fear or reprimand or punishment”.
culture of safety
What does DICOM stand for?
Digital Imaging and Communications in Medicine
What is DICOM?
It is the international standard that specifies protocols for display, transfer, storage, and processing of medical images.
The metadata, located in the “DICOM header” of the image, contains information about the
image, series, exam, patient, imaging facility, and scanner. This information needs to be erased before use in research.
Pediatric dosing
epinephrine
< 30kg: IM Epipen Jr (.15mg)
IM dosing: < 30kg: 0.01 mL/kg (0.01 mg/kg) of 1:1,000 dilution (max single dose of 0.3 mL [0.3 mg]); repeated every 5-15 min needed up to a max dose of 1 mg (1 mL)
IV dosing: 0.1 mL/kg (0.01 mg/kg) of
1:10,000 dilution (maximum single dose of 1mL [0.1 mg]), repeated every 5 – 15 min,
as needed up to a maximum dose of 1 mg
(1 mL)
Atropine dosing
0.6 to 1.0 mg IV, into a running infusion of IV fluids. May repeat atropine up to a total dose of 3 mg.
High risk GBC agents for NSF. Absolutely contraindicated if GFR < 30
Omniscan, Magnevist (and Optimark no longer manufactured)
Low risk GBC agents for NSF (few, if any unconfounded cases)
Prohance, Gadavist, Multihance, Dotarem
Max gray value luminance for mammographic interpretation
420 cd/m2
The ACR-AAPM-SIIM technical standard recommends that ideal reading room ambient lighting fall in the range of
25 to 50 lux.
