RFS news highlights resources, issues, and news relevant to in-training members of the ACR. If you have a topic idea or would like to contribute to the blog, please email RFS Secretary Patricia Balthazar, MD.
RadMeds.com: An Educational Resource
At the start of my pediatric radiology fellowship at the University of Michigan, I accepted a challenge from one of my mentors to read the entire 13th edition of Caffey’s Pediatric Diagnostic Imaging by the end of the year. It was an ambitious but attainable goal, and it was going well until the third week. This is when I found myself, yet again, learning/reviewing management of acute reactions to contrast media. “Why is it,” I thought “that I review this material every year, and I’m still not confident in my ability to apply it?” Worse still, I realized that I had never considered adjusting the doses for kids, and here I was, working at one of the best children’s hospitals in the country!
The root cause of the problem
As radiologists, we rarely administer medications, so it’s not surprising that we only review this information when our institution requires us to. We would rather spend our time reviewing the MR signal characteristics of liver lesions, myelination pattern of the developing brain, or the classification of acetabular fractures. The problem with this approach is summed up by the saying “use it or lose it.” If we only review medication administration principles once a year (or less in some cases), we aren’t adequately prepared to take care of our patients. You would be hard pressed to find a radiologist who would attempt to interpret a complex diagnostic imaging study with only 1-2 hours of training per year.
In addition, when we are called to retrieve this information from deep within our mental rolodex, it’s often in a time-sensitive, high stress, potentially life or death situation. Simply put, we can’t afford to get this wrong.
The call to action
I found myself wondering, “Why isn’t there an easily accessible website that will immediately take me to the information I may need to save a life?” The most important piece of advice I could give to other trainees is if you find yourself asking why something does not exist — create it yourself.
Initially, my intent was to create a resource that would quickly provide information needed in the acute management of allergic-like contrast reactions. I also wanted the site to automatically convert doses for pediatric patients, as this seemed like a potential source of error in caring for children.
Once I had the domain established and started to get more comfortable with web development, I realized there was an opportunity to do much more with the website. I thought “Why not make it a source that radiologists could go to for information on all the medications used in the radiology department?” I knew this would be a lot more work to create and manage over the years, but again found myself thinking “Why doesn’t this already exist?” So in the spirit of “practice what you preach,” I created it myself.
The website currently has information on administering contrast media and managing complications, administering common medications used in IR, administering radiopharmaceuticals (complete with half-lives and photopeaks for the R3s out there), and preparing joint injections. I have carefully considered how radiologists might use the site in practice and hope it is useful for the global radiology community.
You’ll notice that the homepage of the site is “Management of Contrast Reactions.” This is the information you need access to in an emergency, so you shouldn’t have to search for it. I used a color pallet that would be suitable for the radiology reading room, and tried to keep the information concise and streamlined. My goal was to provide a fast and accurate way for radiologists to review medication administration and confirm their prescribed doses for adults and children.