Screen for Absolute and Relative Contraindications:

• Does the patient have a history of anaphylaxis to fluorescein dye? (absolute)

• Does the patient have a history of mild reaction to fluorescein dye (i.e. rash)? (relative)

• Is the patient currently pregnant or breastfeeding? (relative, especially in first trimester)

• Does the patient have renal or liver disease? (not a contraindication, but extra measures should be taken to avoid toxicity)

How do I counsel a patient about the risks of this test?

“IVFA is a dye-based test and therefore, there are certain risks associated with the test, that I need to inform you about.

Most patients can experience:

• Yellowing of their skin 6 to 12 hours post-injection and yellowing of urine for up to 36 hours after the procedure.

• Transient nausea and vomiting during the test (about 10% of patients, although it is a quick onset and resolution).

• Extravasation of dye.

• Transient discolouration at the site of injection.

Less likely adverse risks and events include:

• Mild allergic reactions: Pruritus, dizziness, urticaria (1% to 18% of patients). (1)

• Anaphylaxis: severe allergic reaction involving two or more body systems (0.03% to 0.38%)

• Risk of death is 1 in 100,000 to 1 in 220,000

As this test is happening in a healthcare setting, with nursing present, we are able to monitor for these events and act promptly and accordingly. Do you wish to proceed?”