Diagnostic Radiation Exposure in Pediatric Trauma Patients

Abstract

When the use of radiologic imaging is considered essential, cumulative radiation exposure can be high. In young children with relatively long life spans, the benefit of each imaging study and the cumulative radiation dose should be weighed against the long-term risks of increased exposure.

Analysis of radiation exposure among pediatric trauma patients at national trauma centers

“…In this pediatric-specific study of 506 patients admitted to the trauma service, the mean total effective dose delivered was 14.9 mSv (median, 7.2 mSv). More recently, Brunetti et al 14 published the results of a single pediatric trauma center. In this cohort of 945 children at a Level 1 trauma center, the mean dose for all patients (admitted and discharged from the ED) was 12.8 mSv (range, 0Y73.5 mSv).…”

“…Furthermore, the amount of radiation delivered is impacted by body size, habitus, age, sex, and setting particular to machine. 8 Therefore, we sought to provide reasonable estimates of the amount of radiation exposure based on the work of Mettler et al 2 who provided estimates for exposure for plain radiographs and CT. For CT estimates, we used the work of Thomas et al 19 and Brunetti et al 14 who have previously provided estimates for age-stratified effective doses for common CT examinations.…”

The pediatric cervical spine instability study

“…This issue has been brought to light via multiple studies [3,15], with the risk of delayed malignancy the primary concern. Some calculations suggest that there may be as many as one fatal cancer for every 1,000 CT scans performed in a young child [25].…”

Factors associated with patient exposure and environmental control during pediatric trauma resuscitation

“…The initial examination is important for pediatric trauma patients because children are often unable to communicate their injuries and should have their radiation exposure limited to only clinically driven imaging studies. 2,3 Measures for preventing hypothermia (''environmental control'') are equally important during the resuscitation. When compared with adults, children have thinner skin, less subcutaneous tissue, and a higher body surface areaYtoYmass ratio.…”