Ionising radiation exposure in paediatric trauma

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.