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Ionising radiation exposure in paediatric trauma

N G Patel1, A M Mohamed, G Cooper

  • 1Brighton and Sussex University Hospitals NHS Trust, UK. dr.nimeshpatel1@gmail.com.

Annals of the Royal College of Surgeons of England
|May 1, 2014
PubMed

Insights

Paediatric trauma surgery involves radiation exposure. Junior surgeons used 51% more screening time and 35% more radiation dose area product (DAP) than consultants. Increased consultant presence is recommended to minimize radiation risks in children.

Area of Science:

  • Paediatric surgery
  • Radiology
  • Radiation safety

Background:

  • Trauma is a leading cause of death and disability in children.
  • Intraoperative imaging is frequently used in paediatric trauma care, leading to radiation exposure.
  • Minimizing radiation exposure is crucial due to potential long-term health effects in children.

Purpose of the Study:

  • To quantify the difference in ionizing radiation exposure during paediatric trauma surgery based on surgeon grade.
  • To evaluate the adherence to the 'as low as reasonably achievable' (ALARA) principle in paediatric trauma care.

Main Methods:

  • Retrospective analysis of intraoperative imaging data from paediatric trauma cases (2008-2010).
  • Data collected included injury demographics, surgeon grade, screening time, and dose area product (DAP).
  • All procedures utilized a mobile image intensifier with the lowest dose rate selected.

Main Results:

  • A total of 782 cases were analyzed, involving consultants, senior registrars, and junior registrars.
  • Junior registrars demonstrated significantly longer screening times (0.47 min) and higher DAP (90.46 Gycm²) compared to consultants (0.23 min, 58.49 Gycm²).
  • This represents a 51% increase in screening time and a 35% increase in DAP for junior registrars versus consultants.

Conclusions:

  • Procedures performed by consultants resulted in significantly lower screening times and radiation exposure compared to registrars (p<0.001).
  • The findings suggest variability in radiation management based on surgical experience.
  • Increased consultant supervision in paediatric trauma theatres is recommended to optimize radiation safety for young patients.
Abstract

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