Exposure of Pediatric Emergency Patients to Imaging Exams, Nowadays and in Times of Covid-19: An Integrative Review

Abstract

Objective: To analyze literature data about unnecessary exposure of pediatric emergency patients to ionizing agents from imaging examinations, nowadays and during times of COVID-19. Data sources: Between April and July 2020, articles were selected using the databases: Virtual Health Library, PubMed and Scientific Electronic Library Online. The following descriptors were used: [(pediatrics) AND (emergencies) AND (diagnostic imaging) AND (medical overuse)] and [(Coronavirus infections) OR (COVID-19) AND (pediatrics) AND (emergencies) AND (diagnostic imaging)]. Inclusion criteria were articles available in full, in Portuguese or English, published from 2016 to 2020 or from 2019 to 2020, and articles that covered the theme. Articles without adherence to the theme and duplicate texts in the databases were excluded. Data synthesis: 61 publications were identified, of which 17 were comprised in this review. Some imaging tests used in pediatric emergency departments increase the possibility of developing future malignancies in patients, since they emit ionizing radiation. There are clinical decision instruments that allow reducing unnecessary exam requests, avoiding over-medicalization, and hospital expenses. Moreover, with the COVID-19 pandemic, there was a growing concern about the overuse of imaging exams in the pediatric population, which highlights the problems pointed out by this review. Conclusions: It is necessary to improve hospital staff training, use clinical decision instruments and develop guidelines to reduce the number of exams required, allowing hospital cost savings; and reducing children’s exposure to ionizing agents.

The impact of the COVID-19 pandemic on the use of diagnostic imaging examinations in the Brazilian unified healthcare system (SUS)

“…Even though the benefits of CT imaging in the diagnosis and management of a number of conditions are largely recognized, exposure to ionizing radiation during CT scans is associated with potential increased risk of subsequent cancer development [19] , [20] , [21] , [22] , [23] . As a result, the balance between the need for a CT scan and the associated risks must be considered (justification).…”

“…Conversely, the well-known problem of overuse of medicine [ 17 , 18 ] may have worsened during the COVID-19 pandemic. In particular, the potential over- or misuse of CT scans raises concerns about the potential risks of cancer induction due to exposure to ionizing radiation [19] , [20] , [21] , [22] , [23] .…”

Análisis bibliométrico de la producción científica sobre educación virtual en tiempos de COVID-19

“…El Síndrome Respiratorio Agudo Severo Coronavirus 2 o SARS-CoV-2 surge a finales del 2019 en Wuhan, China (Maltezou et al, 2021;Phan, 2020;Ramírez-Velásquez et al, 2020), siendo el 11 de marzo de 2020 reconocida como pandemia por la Organización mundial de la Salud (OMS) por sus altos niveles de contagio a nivel mundial (Floriani et al, 2022;Gregorio-Chaviano et al, 2020;Wang et al, 2020). Es por ello, que los gobiernos de varios países restringieron la movilidad humana e impusieron el distanciamiento social (Lee et al, 2020;Li et al, 2020) a fin de mitigar la propagación y reducir el contagio por el coronavirus (Heinzerling et al, 2020;Maltezou et al, 2020;Verelst et al, 2020).…”

Covid-19: Bibliometria E Análise Do Perfil Epidemiológico Comparativo De Pacientes Em Hospital De Referência Em Campos Dos Goytacazes

“…A OMS, em 11 de março de 2020, declarou situação de pandemia pela COVID-19. Em 9 de julho do mesmo ano, foram relatados mais de 11,8 milhões de casos e 544 mil óbitos no mundo (FLORIANI, et al, 2020).…”