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Decreasing Radiation Exposure in Pediatric Trauma Related to Cervical Spine Clearance: A Quality Improvement Project

Valerie Ann Waddell1, Susan Connelly

  • 1Department of General Surgery, Trauma and Burn, Children's Mercy, Kansas City, Missouri (Dr Waddell) and Department of Nursing, Creighton University, Omaha, Nebraska (Dr Connelly).

Journal of Trauma Nursing : the Official Journal of the Society of Trauma Nurses
|January 11, 2018
PubMed

Insights

Staff education and a new algorithm significantly reduced radiation exposure from cervical spine clearance in pediatric trauma patients, decreasing CT scans by 47% while ensuring safety.

Area of Science:

  • Pediatric Trauma Care
  • Medical Imaging Safety
  • Radiation Dose Reduction

Background:

  • Accurate and timely evaluation of pediatric cervical spine injuries is crucial to prevent missed diagnoses.
  • Radiologic examinations are essential for pediatric trauma patients due to challenges in clinical examination.
  • Early-life radiation exposure increases pediatric cancer risk, necessitating dose reduction strategies.

Purpose of the Study:

  • To reduce radiation exposure in pediatric trauma patients (≥5 years) undergoing cervical spine clearance.
  • To implement and evaluate an algorithm and staff education for optimizing imaging protocols.

Main Methods:

  • A quality improvement project utilizing a retrospective chart review.
  • Education provided to surgical and emergency department staff on radiation risks and institutional trends.
  • Development and implementation of a diagnostic algorithm for cervical spine clearance imaging.

Main Results:

  • Initial chart review showed cervical spine CT in 34% of patients, averaging 3.5 mSv radiation exposure.
  • Post-intervention, CT use decreased to 18% with an average exposure of 3.2 mSv.
  • This represents a 47% reduction in CT utilization for cervical spine clearance.

Conclusions:

  • Staff education and algorithm use show promise in reducing radiation exposure.
  • The implemented strategies provide safe and effective cervical spine clearance in pediatric trauma.
  • Optimized imaging protocols can minimize risks associated with radiologic evaluations.
Abstract

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