Background:Computed tomography (CT) used in pediatric pediatrics brain injury (TBI) to ascertain neurological manifestations. Nevertheless, this practice is associated with adverse effects. Reports in the literature suggest incidents of morbidity and mortality in children due to exposure to radiation. Hence, it is found imperative to search for a reliable alternative.Objectives:The aim of this study is to find a reliable clinical alternative to detect an intracranial injury without resorting to the CT.Materials and Methods:Retrospective cross-sectional study was undertaken in patients (1-14 years) with blunt head injury and having a Glasgow Coma Scale (GCS) of 13-15 who had CT performed on them. Using statistical analysis, the correlation between clinical examination and positive CT manifestation is analyzed for different age-groups and various mechanisms of injury.Results:No statistically significant association between parameteres such as Loss of Consciousness, ‘fall’ as mechanism of injury, motor vehicle accidents (MVA), more than two discrete episodes of vomiting and the CT finding of intracranial injury could be noted. Analyzed data have led to believe that GCS of 13 at presentation is the only important clinical predictor of intracranial injury.Conclusion:Retrospective data, small sample size and limited number of factors for assessing clinical manifestation might present constraints on the predictive rule that was derived from this review. Such limitations notwithstanding, the decision to determine which patients should undergo neuroimaging is encouraged to be based on clinical judgments. Further analysis with higher sample sizes may be required to authenticate and validate findings.
Background: Analysis of rejected radiographs is an important quality indicator of any radiology department. At King Abdulaziz Medical City (KAMC), about 185,000 radiographs are performed annually. Methods: The rejected radiographs over a period of 5 years were analyzed using a dedicated electronic rejection system. The rejection is performed by a certified radiologist and communicated electronically to the concerned technologist. Results: A total of 455 rejected radiographs were reviewed and analyzed. Of the reviewed rejected radiographs, 247 were adults (60%) whereas 166 were pediatrics (40%). In terms of sex, 231 (56%) of the rejected radiographs were for men and 182 (44%) were for women. The most common reason for rejection was labeling (22%), followed by procedure protocol (20%). Other reasons included positioning (14%), processing (14%), artifacts (13%), wrong documentation (9%), and exposure error (6%). The rejection due to exposure error was very low (6%) owing to the utilization of digital systems that offer a wide exposure latitude. Reported data at hospitals that use analog systems show up to 67% of rejections were due to exposure error. In terms of body parts, the highest rejection was for extremities (43%) followed by chest (31%). The remaining rejected radiographs includes abdomen (9%), spine (8%), pelvis (5%), and head and neck (4%).Conclusion: The outcome of this study can be used to set up training programs to improve radiological services and reduce the unnecessary radiation exposure to the patients.
Introduction Access to ionizing radiation has become widely available for diagnosis and treatment. The increased use of ionizing radiation has been associated with radiation exposure hazards for patients and radiation workers. Raising the level of radiation protection awareness is important to maintain the safety of healthcare settings. Methods Online questionnaires were distributed to 755 healthcare workers and students at King Abdulaziz Medical City and King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. The questionnaire consisted of 14 multiple-choice questions divided into two sections (questions related to radiation protection and common radiologic examination doses). Results In total, 443 participants completed the questionnaire, including 142 (32%) medical students, 107 (24%) radiology technologists, 105 (24%) radiography students, and 89 (20%) physicians. Of the participants, 245 (55%) were men. A total of 74 (84%) physicians and 51 (47%) radiology technologists had more than 5 years of experience. Eleven (12%) physicians and 44 (41%) radiology technologists had 1–4 years of experience, whereas the rest had less than 1 year of experience. Only 16% of participants attended training courses on a regular basis. However, 15% of the participants thought that they had excellent knowledge of radiation protection, whereas 18% admitted that they did not have sufficient knowledge. Sixty-two percent of the questions related to radiation protection awareness were answered correctly. Forty-five percent of the participants correctly answered questions related to doses from common radiologic examinations. Only 23% and 16% of participants were aware of the noncontrast chest CT and lumbar x-ray doses, respectively. Moreover, 35% and 24% of participants did not know that pelvic MRI and abdominal ultrasound do not contribute any radiation dose, respectively. Conclusion The results showed a knowledge gap regarding radiation protection and dose levels; therefore, periodic refresher courses are recommended for healthcare workers in order to increase the level of awareness.
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