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Improved pediatric multidetector body CT using a size-based color-coded format
Donald P Frush1, Britt Soden, Karen S Frush
1Division of Pediatric Radiology, Department of Radiology, McGovern-Davison Children's Health Center, Rm. 1905, Duke University Health System, Box 3808, Erwin Rd., Durham, NC 27710, USA.
Insights
Color-coded CT protocols significantly reduce errors in pediatric imaging compared to conventional methods. Technologists also preferred the color-coded system for its ease of use and clarity.
Area of Science:
- Radiology
- Medical Imaging
- Pediatric Imaging
Background:
- Pediatric CT technique requires specific adjustments for infants and children.
- The Broselow-Luten pediatric system, a size-based color-coded tool, simplifies pediatric care and reduces medical errors.
- This color-coded system can be adapted for CT protocols.
Purpose of the Study:
- To compare error occurrence between conventional and color-coded pediatric multidetector body CT protocols.
- To assess technologist preference for conventional versus color-coded CT protocol formats.
Main Methods:
- Multidetector CT examinations were conducted using conventional or color-coded formats for 6-week periods.
- Variations from protocol parameters (tube current, detector configuration, table speed, IV contrast dose) were recorded.
- CT technologists (n=20) completed a survey on format preference, ease of use, and clarity.
Main Results:
- The color-coded group showed significantly fewer overall errors (p < 0.01).
- Error percentages for radiation dose parameters (tube current, detector configuration, table speed) were significantly lower in the color-coded group (p < 0.05).
- The color-coded format was overwhelmingly preferred by technologists (p < 0.0003).
Conclusions:
- Color-coded CT formatting, an extension of existing clinical systems, offers an efficient and consistent approach for pediatric body CT.
- This system simplifies protocol use and reduces variations (errors) in radiology departments.
- The color-coded system is a preferable format for general pediatric body CT protocols.
Objective:
CT technique should be adjusted while scanning infants and children. One format that has proven successful in simplifying pediatric care and reducing medical error is the size-based, color-coded Broselow-Luten pediatric system. This color-coded system can serve as a format for CT protocols. The purpose of this investigation was to compare variation (or error) occurrence and technologist preference for conventional and color-coded formats for pediatric multidetector body CT protocols.
Materials And Methods:
Multidetector CT examinations were set up using either a conventional or a color-coded format for a period of 6 weeks each. Variations (errors) from protocol parameters (including tube current, detector configuration, table speed, and IV contrast media dose) were tabulated. Qualitative assessment consisted of a survey of CT technologists (n = 20) for preference in six areas related to ease of use and clarity of the formats.
Results:
There were 44 CT examinations (n = 30 infants and children) in the conventional group and 55 CT examinations (n = 31 infants and children) in the color-coded protocol format group. Overall, the number of errors was significantly less in the color-coded group (p < 0.01), with a significantly lower error percentage in individual parameters affecting radiation dose, including tube current, detector configuration, and table speed (p < 0.05). In all areas, the color-coded format was preferred over the conventional format (p < 0.0003).
Conclusion:
Color-coded CT formatting is an extension of a clinical color-coded system. This system provides an easy, expeditious, consistent, and preferable format for general pediatric body CT protocols. Most importantly, the color-coded system can reduce variations (errors) in the radiology department.