E2929. Sustainability of Multi-Dose Contrast Injection: A Single-Center Experience
  1. Roozbeh Houshyar; University of California - Irvine Medical Center
  2. David Kakish; University of California - Irvine Medical Center
  3. Justin Glavis-Bloom; University of California - Irvine Medical Center
  4. Sungmee Park; University of California - Irvine Medical Center
  5. Vahid Yaghmai; University of California - Irvine Medical Center
The healthcare sector in the United States is responsible for an estimated 8.5% of total greenhouse gas emissions. Due to their intense energy utilization, radiology departments are increasingly facing scrutiny as hospital systems become more conscious of their impact as well as the costs to their bottom lines. In spite of this, there has not been much focus on a reduction in material waste. In this study, we aim to evaluate the sustainability of syringeless multidose contrast injection in our emergency department computed tomography (CT) suite.

Materials and Methods:
Intravenous contrast injections, contrast volumes, and injection materials utilized per examination utilizing a multidose injector were analyzed for all contrast-enhanced CTs performed in the emergency department at our level 1 trauma academic medical center from January through June 2022. Utilizing dose and injection data for the above dates, we extrapolated the relevant date for comparison to dual syringe single-dose power injection. Each standard single-dose power injection utilizes a single-use contrast vial, a single-use 50 mL saline bag, two single-use syringes, and single-use tubing which connects to a patient’s intravenous cannula. The multidose power injection device requires two 500 mL contrast vials and a 1000 mL intravenous saline bag, which can be used for up to eight continuous hours. The tubing required consists of single-use spike tubes that connect to the contrast vials and the saline, pump tubes that connect to the spike tubes, and single-use patient tubes that connect to patients’ intravenous cannulas.

A total of 7850 CT contrast injections were included in the study. The mean number of spikes used per multidose contrast injection was significantly lower than the mean number of syringes used per single-dose contrast injection (0.237 spikes versus 2 syringes, p < 0.001). On the other hand, the mean amount of tubing used per injection was slightly higher with the multi-dose contrast injector (1.023 tubing vs 1 tubing, p < 0.001). The mean numbers of intravenous saline bags and contrast vials used per injection was significantly lower with the multidose contrast injector (0.05 bags versus 1 bag /injection, p < 0.001 and 0.188 vial versus 1 vial /injection, p < 0.001, respectively). Finally, there was significantly decreased contrast volume wasted per injection with multi-dose contrast injection (1.18 mL vs 1.84 mL /injection, p < 0.001).

Our institution’s experience with a multidose contrast injector demonstrated a marked reduction in material waste in comparison to a standard single-use contrast injector in the emergency CT setting. Multidose contrast injection ameliorates waste, facilitates the sustainability, and reduces associated costs.