DIAGNOSTIC IMAGING AND IONIZING RADIATION EXPOSURE IN A LEVEL 1 TRAUMA CENTRE POPULATION MET WITH TRAUMA TEAM ACTIVATION: A ONE-YEAR PATIENT RECORD AUDIT.

Anna Bågenholm,Pål Løvhaugen,Rune Sundset,Tor Ingebrigtsen

doi:10.1093/rpd/ncaa010

Abstract

This audit describes ionizing and non-ionizing diagnostic imaging at a regional trauma centre. All 144 patients (males 79.2%, median age 31years) met with trauma team activation from 1 January 2015 to 31 December 2015 were included. We used data from electronic health records to identify all diagnostic imaging and report radiation exposure as dose area product (DAP) for conventional radiography (X-ray) and dose length product (DLP) and effective dose for CT. During hospitalization, 134 (93.1%) underwent X-ray, 122 (84.7%) CT, 92 (63.9%) focused assessment with sonography for trauma (FAST), 14 (9.7%) ultrasound (FAST excluded) and 32 (22.2%) magnetic resonance imaging. One hundred and sixteen (80.5%) underwent CT examinations during trauma admissions, and 73 of 144 (50.7%) standardized whole body CT (SWBCT). DAP values were below national reference levels. Median DLP and effective dose were 2396 mGycm and 20.42mSv for all CT examinations, and 2461 mGycm (national diagnostic reference level 2400) and 22.29mSv for a SWBCT.

Highlights

The introduction of conventional radiography (X-ray) in 1895 and computer tomography (CT) in 1971 has increased the burden of manmade ionizing radiation to humans[1]
We report the number of X-ray images and CT scans with missing dose area product (DAP) and dose length product (DLP) values
Median DLP and effective dose for all CT examinations during the total hospitalization were 2396 mGycm and 20.42 mSv, respectively. Most of this dose was delivered during trauma admissions, as the median DLP increased with only 300 mGycm during the subsequent hospital stay

Summary

Introduction

The introduction of conventional radiography (X-ray) in 1895 and computer tomography (CT) in 1971 has increased the burden of manmade ionizing radiation to humans[1]. The majority of patients with severe trauma are between 20 and 60 years[6, 9, 13, 14, 18, 19]. For this patient group, a high ionizing radiation dose can be more harmful than the injuries, if injuries are not severe or life threatening. Body size, irradiated body area, machine protocol parameters and use of non-ionizing methods influence the dose the patient receives[2, 20,21,22]

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