Healthcare professionals have acknowledged that children are at risk of radiation overexposure during CT scans and are developing strategies to minimize this risk.
Bumps and bruises are common childhood injuries from which children quickly recover. Unfortunately, some childhood injuries are much more serious and require hospitalization. An article recently published on the American website DOTmed revealed that children who enter the ER with head injuries may, unfortunately, be at risk of radiation overexposure from the equipment used to assess their injuries – the computed tomography (CT) scanner. The dose of radiation received from one CT scan is equivalent to that received from approximately 200 chest X-rays. This is of particular significance as exposure to too much radiation, whether in one exposure or as an accumulation of several exposures, can increase the risk of developing cancer.
This issue prompted the formation of the Safe CT Imaging Collaborative, an initiative set up by the New Jersey Council of Children’s Hospitals and the Institute for Quality and Patient Safety at the New Jersey Hospital Association (NJHA). The aim was to develop guidelines that outline when CT scans should be used and list the radiation dosage limits for children. The Collaborative collected data on CT-scan usage on children under 17 years of age from 71 acute hospitals throughout New Jersey between 2015 and 2016. It found that approximately 50% of children who enter the ER with a head injury underwent a CT scan, regardless of the severity of the injury. Although CT scans are not required for minor head injuries, some hospitals may still assess the extent of the injury using this technique. Also, there was a high degree of variation among hospitals in the numbers of CT scans performed. Some hospitals performed many CT scans where others did not, but the reasons behind this variation were not clear.
Using this data, the NJHA devised charts outlining the circumstances for which CT scans should be performed for children. These charts were provided to emergency room physicians and nurses throughout New Jersey. The Collaborative and NJHA also hosted educational programs promoting safe CT practices and devised information packages for patients and their families explaining when CT scans may not be an appropriate option for children. In addition, the NJHA developed a #ScanSmart toolkit, which is designed to help healthcare professionals educate parents and members of the community who work with children about CT scans.
The Collaborative is hopeful that these guidelines will be adopted and implemented in all New Jersey hospitals with the ultimate goal of reducing unnecessary radiation overexposure in children. It appears that the program has had some success. To date, 47 hospitals have promised to reduce the number of unnecessary CT scans, and there has been a 25% decrease in unnecessary CT scans during the last 12 months. With time, hopefully, all hospitals across New Jersey, and perhaps even nationwide, will follow suit and take the recommended steps towards preventing radiation overexposure in children.
Written by Natasha Tetlow, PhD
Reference: Fischer J. Children undergoing CT scans for head injuries at risk for radiation overexposure. 2017. Available from: www.dotmed.com.