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Some emergency department (ED) patients undergoing computed tomography (CT) imaging with IV contrast have a history of allergic reactions to the contrast, necessitating steroid premedication. While premedication protocols vary, the most common involves 13 hours of intermittent oral steroid doses, often resulting in inpatient admission to prevent prolonged ED stays. In a retrospective noninferiority study, these investigators compared rates of breakthrough allergic reactions for patients with a history of IV contrast allergy who were treated with either a 13-hour oral steroid protocol or a 5-hour IV steroid protocol.
The analysis included 202 patients treated with the 5-hour IV protocol at a single institution over an 8-year period and a prev…