Have the UK Pediatric Trauma Protocols resulted in a reduction in chest computed tomography imaging for children presenting with major blunt trauma?
Abstract Objectives To observe variation in imaging requests after publication of the Royal College of Radiologists UK Paediatric Trauma Protocols in 2014, recommending limited use of thoracic computed tomography (CT) to appropriately clinically risk stratified children. Method A retrospective obser...
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Elsevier
2023-10-01
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| Series: | Journal of the American College of Emergency Physicians Open |
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| Online Access: | https://doi.org/10.1002/emp2.13041 |
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| author | Samantha Negus Omar Bouamra Damian Roland |
| author_facet | Samantha Negus Omar Bouamra Damian Roland |
| author_sort | Samantha Negus |
| collection | DOAJ |
| description | Abstract Objectives To observe variation in imaging requests after publication of the Royal College of Radiologists UK Paediatric Trauma Protocols in 2014, recommending limited use of thoracic computed tomography (CT) to appropriately clinically risk stratified children. Method A retrospective observational study using data from the Trauma Audit & Research Network in the United Kingdom, for children (0–16 years of age) for the years 2012–2021. Percentages were calculated to facilitate comparison between year groups (under 1 year of age, 1–10 years of age, 11–15 years of age), and CT imaging categories reviewed: (1) whole‐body CT (WBCT); (2) abdominopelvic CT (CTAP) with chest radiograph (CXR); (3) chest, abdomen, and pelvic CT (CTCAP) with CXR; (4) CTCAP without CXR; and (5) other imaging. Results Increased use of the recommended protocol (CXR with CTAP) was observed after guidance publication but was not sustained: infants under 1 year old, 0.0% in 2012, 7% in 2017, 0.0% in 2021; 1–10‐year‐olds, 4% in 2012, 13.9% in 2017, 5.5% in 2021; 11–15‐year‐olds, 7.1% in 2012, 10.2% in 2017, 6.6% in 2021. Requests for WBCT increased from 2012–2021 (all age groups, 2.4%, 2012, to 5.3%, 2021) and requests for CTCAP were consistently at a higher level than that of the recommended protocol. Conclusion The increased use of CXR with CTAP after publication of the guidelines, was not sustained with a decreasing trend observed from ∼2017, raising concern for the ionizing radiation burden in this population. |
| format | Article |
| id | doaj-art-0cc58428a0c84112bbdb335c9eaa2497 |
| institution | OA Journals |
| issn | 2688-1152 |
| language | English |
| publishDate | 2023-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj-art-0cc58428a0c84112bbdb335c9eaa24972025-08-20T02:03:01ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522023-10-0145n/an/a10.1002/emp2.13041Have the UK Pediatric Trauma Protocols resulted in a reduction in chest computed tomography imaging for children presenting with major blunt trauma?Samantha Negus0Omar Bouamra1Damian Roland2Radiology Department East Surrey Hospital Redhill Surrey UKThe Trauma Audit & Research Network University of Manchester Manchester UKPaediatric Emergency Medicine Leicester Academic (PEMLA) Group Children's Emergency Department Leicester Royal Infirmary Leicester UKAbstract Objectives To observe variation in imaging requests after publication of the Royal College of Radiologists UK Paediatric Trauma Protocols in 2014, recommending limited use of thoracic computed tomography (CT) to appropriately clinically risk stratified children. Method A retrospective observational study using data from the Trauma Audit & Research Network in the United Kingdom, for children (0–16 years of age) for the years 2012–2021. Percentages were calculated to facilitate comparison between year groups (under 1 year of age, 1–10 years of age, 11–15 years of age), and CT imaging categories reviewed: (1) whole‐body CT (WBCT); (2) abdominopelvic CT (CTAP) with chest radiograph (CXR); (3) chest, abdomen, and pelvic CT (CTCAP) with CXR; (4) CTCAP without CXR; and (5) other imaging. Results Increased use of the recommended protocol (CXR with CTAP) was observed after guidance publication but was not sustained: infants under 1 year old, 0.0% in 2012, 7% in 2017, 0.0% in 2021; 1–10‐year‐olds, 4% in 2012, 13.9% in 2017, 5.5% in 2021; 11–15‐year‐olds, 7.1% in 2012, 10.2% in 2017, 6.6% in 2021. Requests for WBCT increased from 2012–2021 (all age groups, 2.4%, 2012, to 5.3%, 2021) and requests for CTCAP were consistently at a higher level than that of the recommended protocol. Conclusion The increased use of CXR with CTAP after publication of the guidelines, was not sustained with a decreasing trend observed from ∼2017, raising concern for the ionizing radiation burden in this population.https://doi.org/10.1002/emp2.13041chest injurieschildcomputed tomographyprotocol compliance |
| spellingShingle | Samantha Negus Omar Bouamra Damian Roland Have the UK Pediatric Trauma Protocols resulted in a reduction in chest computed tomography imaging for children presenting with major blunt trauma? Journal of the American College of Emergency Physicians Open chest injuries child computed tomography protocol compliance |
| title | Have the UK Pediatric Trauma Protocols resulted in a reduction in chest computed tomography imaging for children presenting with major blunt trauma? |
| title_full | Have the UK Pediatric Trauma Protocols resulted in a reduction in chest computed tomography imaging for children presenting with major blunt trauma? |
| title_fullStr | Have the UK Pediatric Trauma Protocols resulted in a reduction in chest computed tomography imaging for children presenting with major blunt trauma? |
| title_full_unstemmed | Have the UK Pediatric Trauma Protocols resulted in a reduction in chest computed tomography imaging for children presenting with major blunt trauma? |
| title_short | Have the UK Pediatric Trauma Protocols resulted in a reduction in chest computed tomography imaging for children presenting with major blunt trauma? |
| title_sort | have the uk pediatric trauma protocols resulted in a reduction in chest computed tomography imaging for children presenting with major blunt trauma |
| topic | chest injuries child computed tomography protocol compliance |
| url | https://doi.org/10.1002/emp2.13041 |
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