A contrast decision with an oversimplified medicine rule

A service receives a request for an indicated contrast-enhanced examination for a person taking metformin. A draft checklist tells staff to stop the medicine for every contrast procedure and restart it after a fixed interval without reviewing renal function, current illness, route or the actual clinical guidance. Another staff member thinks the medicine should never be discussed because it does not itself cause an allergic-like contrast reaction. The request includes no complete medical history or appropriate individualized decision. The team must identify the information and responsibility needed before proceeding. This exercise does not provide a prescription, a hydration rate or a rule that every patient below one laboratory value must be denied imaging.