Get Acr Nrdr Ice Registry Iv Contrast Extravasation

Filling out the ACR NRDR ICE Registry IV Contrast Extravasation form is crucial for documenting incidents of contrast extravasation. This guide provides clear, step-by-step instructions to ensure a thorough and accurate submission of the form.

Follow the steps to complete the ACR NRDR ICE Registry IV Contrast Extravasation form online.

1. Press the ‘Get Form’ button to access and open the form in your preferred online platform.
2. Review the auto-filled sections for submission period, facility number, and report number to ensure accuracy.
3. In the demographics section, enter the patient's age, select their gender, and indicate their status (inpatient, outpatient, emergency department, or other) by checking the appropriate box.
4. Provide information on the contrast used by selecting the brand name, concentration, and injection method. Specify the injection rate as needed.
5. Fill out the catheter details including the gauge, type, and location, along with a response to whether the catheter was placed by radiology.
6. Estimate the volume of contrast extravasated and select the corresponding option for partial, complete, or unknown extravasation.
7. Select all possible contributing factors that may have led to the extravasation incident.
8. Describe initial interventions performed, including any observation required for the patient.
9. Document the initial signs or symptoms exhibited at the time of extravasation, indicating severity when applicable.
10. After two weeks, determine the outcome of the incident by answering whether symptoms resolved, if surgery was required, and if there were any long-term disabilities.
11. Assess and indicate the severity of the injury based on the observed signs and symptoms.
12. Provide any additional comments relevant to the incident.
13. Enter the first and last name of the person who completed the form, ensuring that all required fields are filled correctly.
14. Once all sections are complete, review your responses for accuracy before saving your changes, downloading, printing, or sharing the completed form.

Ensure accurate reporting by completing the ACR NRDR ICE Registry IV Contrast Extravasation form online today.