Rapid Response to the Acute Iodinated Contrast Shortage During the COVID-19 Pandemic: Single-Institution Experience

Omary, Reed A.; Allen, Laveil M.; Davis, L. Taylor; Savoie, Brent; Dyer, Katherine Frederick –; Stokes, LeAnn S.; Pruthi, Sumit; Shechtel, Joanna; Allen, Sarah; Frazier, Sheryl Redlin; Henry, Cameron

doi:10.1016/j.jacr.2022.05.005

Cited by 21 publications

(27 citation statements)

References 4 publications

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“…Radiology has seen shortages of helium impacting MRI. The shutdown of the Shanghai contrast manufacturing plant during the 2022 summer due to a COVID lockdown resulted in a global reduction of iodinated contrast for over 2 months with extensive changes in clinical practice ( 32 , 33 ). Much of the supply chain issues are external to hospitals but they will impacted by them.…”

Section: Discussionmentioning

confidence: 99%

Scenario Planning Approach to Adapting in the COVID Era

Rawson

Stevens

2023

Academic Radiology

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Section: Discussionmentioning

confidence: 99%

Scenario Planning Approach to Adapting in the COVID Era

Rawson

Stevens

2023

Academic Radiology

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“…A related study by Allen et al during routine availability of ICM described successful mitigation tactics to reduce i.v. contrast use by 50% for interventional radiology, interventional neurology, interventional cardiology, and electrophysiology [ 5 ]. Numerous statements and strategies have recently been published on addressing the ICM shortage [ 1 , 3 , 4 , 7 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…These workflows focused on decreasing iodinated contrast media utilization across different specialties such as emergency medicine, radiology, neurology, cardiology, and vascular surgery [ 4 ]. These efforts have reported contrast utilization reduction rates of up to 85% [ 1 , 5 ]. The American College of Radiology (ACR) has also published recommendations for the judicious use of ICM and alternative imaging studies.…”

Section: Introductionmentioning

confidence: 99%

The Effect of an Iodinated Contrast Material Shortage on Ordering Patterns in the Emergency Department

Hahn¹,

Chacko²,

Mohan³

et al. 2022

Cureus

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IntroductionIodinated contrast media (ICM) is essential to emergency department care in differentiating and delineating life-threatening pathologies. In May 2022, due to the COVID-19 outbreak, there was an unprecedented disruption in the manufacturing of iodinated contrast. The primary goal of this study was to describe the effects of an ICM shortage on the ordering patterns of emergency medicine physicians. MethodsThis was a retrospective, observational study with a pre-/post-test design. The study included two 28-day periods. All subjects who underwent a CT were included in the study. The subgroup of patients who underwent a repeat CT with ICM contrast within 1-24 hours was identified. ResultsDuring the pre-and post-implementation study periods, 4,574 and 3,973 CT studies were performed. The median length of stay (p=0.013) and time to first CT (p<0.001) both decreased during the postimplementation period. During the post-implementation period, more non-contrast CTs were ordered (p<0.001). During the post-implementation period, there was an increase in non-contrast studies followed by a repeat study with contrast (p=0.003). ConclusionsA global ICM shortage resulted in a shift in the ordering patterns of Emergency Medicine (EM) physicians. More non-contrast CT scans were ordered. However, there was also an increase in repeat imaging with ICM material.

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“…is further provided us to aggressively reduce the overall daily utilization across the enterprise by around 60-80% [Figure 2]. [5,14] Key strategic initiatives ey were identifying strategies that decreased contrast usage and addressing the high-impact factors initially was the key to navigate the ICM production shortage successfully. Our steps mirrored the strategic actions taken by multiple other institutions and are consistent with ACR recommendations with overarching goals of extending contrast supply run rate and reducing waste.…”

Section: Overarching Strategy and Background Analysismentioning

confidence: 99%

Metrics-driven successful strategy by emergency and radiology driven task force to mitigate global CT contrast media shortage in a safety net hospital

Gopireddy

Virarkar

Vulasala

et al. 2023

JCIS

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Iodinated contrast media (ICM) shortages and secondary supply chain problems due to Coronavirus Disease lockdowns in China significantly impacted radiology operations nationwide. The lack of ICM necessitated operational workflow changes designed to ration contrast use, particularly in the hospital setting. In this manuscript, we share our strategic methods with advanced process/outcome metrics to monitor the effectiveness of our strategy under a coordinated multidisciplinary team effort. Alternate studies such as substituting magnetic resonance angiography for computed tomographic angiography for emergency department patients were studied to measure the suitability of these examinations for specific diagnoses. This article presents readers with a comprehensive crisis management strategy deployed at our institution, emphasizing various options with a limited ICM supply, and minimizing the impact on clinical care.

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Rapid Response to the Acute Iodinated Contrast Shortage During the COVID-19 Pandemic: Single-Institution Experience

Cited by 21 publications

References 4 publications

Scenario Planning Approach to Adapting in the COVID Era

Scenario Planning Approach to Adapting in the COVID Era

The Effect of an Iodinated Contrast Material Shortage on Ordering Patterns in the Emergency Department

Metrics-driven successful strategy by emergency and radiology driven task force to mitigate global CT contrast media shortage in a safety net hospital

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