RESUMO
Studies have shown that life-threatening contrast agent reactions in adults are very rare, and even less common in children. The rarity of severe allergic reactions to contrast material challenges educators to achieve radiology resident competency in this setting. However, using a simulated anaphylactic contrast reaction paradigm, we have drawn two conclusions: (1) Residents are insufficiently prepared to recognize and manage these life-threatening events and (2) with an interactive, computer-based tool we can significantly improve resident performance in these situations. Simulation is a growing tool in medicine and allows standardized resident exposure to uncommon events in a setting that is conducive to resident education without fear of repercussions (see Ruddy and Patterson in this issue of Pediatric Radiology). More important, simulation provides a cornerstone in patient safety resident education without putting patients at risk.
Assuntos
Anafilaxia/diagnóstico , Anafilaxia/terapia , Meios de Contraste/efeitos adversos , Educação de Pós-Graduação em Medicina/métodos , Medicina de Emergência/educação , Simulação de Paciente , Pediatria/educação , Radiologia/educação , Gestão da Segurança/métodos , Humanos , Internato e Residência , Avaliação das Necessidades , Gravação em VídeoRESUMO
We describe the use of a dual-source 64-channel multidetector array CT (MDCT) scanner in the evaluation of a coronary-cameral fistula in a 10-month-old boy. Echocardiography, cardiac catheterization, and MRI are modalities often used to evaluate congenital and other pediatric heart diseases. Radiation dose concerns and the absence of established protocols are factors that have potentially limited the use of CT for work-up in these young children. We present a case in which recent advances in technology allowed effective low-dose diagnostic quality coronary MDCT angiography in an infant.
