Authors (including presenting author) :
Chan YS(1)(2), Chan YH(1)(2), Tong SLC(1)(2), Cho CMC(1)(2), Lee WK(1)
Affiliation :
(1)Department of Imaging and Interventional Radiology, Prince of Wales Hospital, (2) Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong
Introduction :
An empirical fasting period of at least 4 hours prior to contrast administration for CT scanning has been an age-old practice in HA. This creates patient discomfort, may impact on the diabetic control, and limits scan slots arrangement in urgent setting. The effect is further compounded by the rising number of urgent imaging requests, and patients may need to be repeatedly fasted while awaiting for scanning slots. International guidelines have been recently updated stating that with the improved safety profile of currently used contrast media, fasting is no longer routinely required.
Objectives :
We aim to audit the current clinical practice in terms of fasting prior to contrast CT in Prince of Wales Hospital, establish the local safety profile, and implement changes complying to international standards.
Methodology :
Baseline audit was carried out in Jan to Feb 2021 in our department, establishing the rate of vomiting and aspiration subsequent to contrast administration for CT scans. Stepwise policy change was made to implement the non-fasting policy prior to contrast CT to phase out the old 4-hour fasting rule. Three further rounds of audits rounds were carried out after each policy change to further consolidate the safety profile of contrast media use and the new policy.
Result & Outcome :
First round of audit found fasting rate of 95.3% for contrast CT attendances in our department. We have fully adopted the non-fasting policy prior to contrast CT in Prince of Wales Hospital since 6th September 2021, with rising proportion of non-fasted patients throughout the subsequent three rounds of audit. Total 4357 CT attendances were included in 4 rounds of audits. Contrast administration is proven to have a very low risk of vomiting (0.1%, 6 patients), with no aspiration identified in these patients.
