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Comparison of radiation exposure of trauma patients from diagnostic radiology procedures before and after the introduction of a panscan protocol

TitleComparison of radiation exposure of trauma patients from diagnostic radiology procedures before and after the introduction of a panscan protocol
Publication TypeJournal Article
Year of Publication2012
AuthorsAsha, S, Curtis, KA, Grant, N, Taylor, CB, Lo, SK, Smart, R, Compagnoni, K
JournalEmergency Medicine Australasia
Volume24
Pagination43-51
Date Published02/2012
ISBN Number1742-6723 (Electronic)1742-6723 (Linking)
Accession Number22313559
Abstract

Objectives: To compare the proportion of patients exposed to a radiation dose in excess of 20 mSv, and to document missed injuries before and after the introduction of a panscan protocol for blunt trauma. Methods: Data were collected retrospectively from our trauma database for 6 months before and after implementation of the protocol. All radiological studies performed during the initial patient assessment were identified. Radiation doses for each patient were calculated. Subgroup analyses were age

30 years, injury severity score (ISS) <16 and >/=16, and patient disposition as discharged from ED or admitted. Results: There were 656 patients before and 624 after the introduction of the protocol. The proportion of patients exposed to a radiation dose >20 mSv increased by 8% (95% confidence interval [CI] 4-12), which equated to one extra person being exposed to >20 mSv for every 13 patients treated after the introduction of the protocol. The odds of receiving a radiation dose >20 mSv after the introduction of the protocol compared with the odds before were increased across all subgroups (

30 years: OR 2.2, 95% CI 1.5-3.4, P < 0.001; ISS < 16: OR 2.4, 95% CI 1.5-3.9, P < 0.001; ISS >/= 16: OR 2.0, 95% CI 1.0-3.7, P = 0.04; discharged home: OR 2.1, 95% CI 0.7-6.0, P = 0.17; admitted: OR 2.2, 95% CI 1.5-3.3, P < 0.001). There were six missed injuries before and four after. Conclusions: Introduction of a panscan protocol increased the proportion of trauma patients receiving a radiation dose >20 mSv. This increased risk occurred regardless of age or injury severity.

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