Quantitative Assessment of Diagnostic Radiation Doses in Adult Blunt Trauma Patients

Winslow, James E.; Hinshaw, Jeffrey W.; Hughes, Michael; Williams, Robert T.; Bozeman, William P.

doi:10.1016/j.annemergmed.2007.12.019

Cited by 56 publications

(33 citation statements)

References 7 publications

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“…Additionally, the standard practice protocols for evaluating patients extricated and immobilized on arrival at the trauma center have trended toward pan-scanning (18). Using principles of selective spinal immobilization as has been advocated by others, we are of the opinion that full spinal immobilization in a conscious, cooperative, neurologically intact driver without focal severe spinal pain or neurological symptoms suggestive of spinal cord or nerve root injury is rarely necessary (8,19,20).…”

Section: Discussionmentioning

confidence: 98%

Radiation Exposure as a Consequence of Spinal Immobilization and Extrication

Stevens

Trammell

Billows

et al. 2015

The Journal of Emergency Medicine

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Section: Discussionmentioning

confidence: 98%

Radiation Exposure as a Consequence of Spinal Immobilization and Extrication

Stevens

Trammell

Billows

et al. 2015

The Journal of Emergency Medicine

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“…During the study period, 60 major trauma patients were admitted to our centre, 36 of which met inclusion criteria (78% male with median (IQR) age 38 (27-68) years) with a median (IQR) ISS of 25 (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34) and ICU stay of 5 (2-10) days. Injuries were predominantly due to blunt trauma (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

“…It is of note that a subset of more severely injured patients in this cohort received radiation doses from CT in excess of 100 mSv. Winslow et al 19 looked at the radiation dose in the first 24 h received by less severely injured US trauma patients. In all, 92% of their population had a whole-body CT ('pan-scan'), and the median dose was 40.2 mSv.…”

Section: Discussionmentioning

confidence: 99%

Cumulative radiation dose due to diagnostic investigations in seriously injured trauma patients admitted to critical care

Leeson

Adiotomre

Mannings

et al. 2014

Journal of the Intensive Care Society

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A retrospective review of case notes and radiology records was performed in order to estimate the amount and sources of ionising radiation multiply injured trauma patients are exposed to, during their initial investigations and subsequent critical care admission. Data were available for 431 radiological investigations from 36 patients. Results showed initial emergency department imaging (combined computed tomography (CT) and plain radiographs) contributed 70% of the total radiation dose. Overall, CT scans were responsible for 80% and plain radiographs 15% of the total radiation dose. Plain radiographs performed after the initial resuscitation period contributed the greatest number of investigations but accounted for only 8% of total radiation exposure. Median cumulative effective dose was estimated to be between 16 and 29 millisieverts, resulting in an estimated increased life time risk of carcinogenesis of between 1 in 614 and 1 in 1075 above baseline.

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“…1,2 CT use in the investigation of trauma patients has increased significantly during the past two decades, 3 which may further increase the burden of radiationinduced malignancy on society. Several recent studies [4][5][6][7][8][9] have examined the radiation dose to trauma patients during their hospital stay, but only one study 8 has examined the radiation exposure associated with the patient's resuscitative phase of care and diagnosis. This study by Winslow et al excluded the most severelyinjured patients and did not consider tests done at referring centres, despite evidence to show that patients who are transferred from regional centres have higher total doses of radiation than those imaged at the trauma centre only.…”

Section: Introductionmentioning

confidence: 99%

Radiation Exposure From CT Scanning in the Resuscitative Phase of Trauma Care: A Level One Trauma Centre Experience

Beatty

Furey

Daniels

et al. 2015

CJEM

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ObjectivesThe initial management of a trauma patient often involves imaging in the form of x-rays, computed tomography (CT) and other radiographic studies, which expose the patient to ionizing radiation, an entity known to cause tissue injury and malignancy at high doses. The purpose of this study was to use a calculation-based method to determine the radiation exposure of trauma patients undergoing trauma team activation in a Canadian tertiary-care trauma centre.MethodsA retrospective chart review was conducted using the Nova Scotia Provincial Trauma Registry. All patients age 16 years old and over who underwent trauma team activation between March 1, 2008 and March 1, 2009 were included. Patients who died prior to imaging tests were excluded. Dose reports for each CT were used to calculate a whole-body radiation dose for each patient.ResultsThere were 230 trauma team activations during the study period, of which 206 had CT imaging. Data were available for 162 patients. The mean whole-body radiation exposure for all patients was 24.4±10.3 mSv, which may correlate to one additional cancer death for every 100 trauma patients scanned.ConclusionsTrauma patients are exposed to significant amounts of radiation during their initial trauma work-up, which may increase the risk of fatal cancer. Clinicians who care for these patients must be aware of the radiation exposure, and take measures to limit radiation exposure of trauma patients.

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Quantitative Assessment of Diagnostic Radiation Doses in Adult Blunt Trauma Patients

Cited by 56 publications

References 7 publications

Radiation Exposure as a Consequence of Spinal Immobilization and Extrication

Radiation Exposure as a Consequence of Spinal Immobilization and Extrication

Cumulative radiation dose due to diagnostic investigations in seriously injured trauma patients admitted to critical care

Radiation Exposure From CT Scanning in the Resuscitative Phase of Trauma Care: A Level One Trauma Centre Experience

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