Our patient needs the study now. What else can we do?

Intravenous hydrocortisone at 200 mg can be used but the ACR recommends at least a 6 hours before doing the study. In emergent situations IV hydrocortisone (200 mg) plus H-1 antihistamine (50 mg benadryl) one hour pre-study has been used. In addition to premedication please speak to the radiologist responsible for the study to make sure they recognize the high risk patient and additional care and observation of the patient is needed. Remember that pre-medication helps reduce the risk of a reaction but does not eliminate the risk.