Objective The use of computed tomography (CT) in pediatric patients has decreased since the association between radiation and cancer risk has been reported. However, in adolescent patients being treated as adult patients, there has been a high incidence of CT use in emergency departments (EDs). Thus, this study aimed to evaluate the CT use in adolescent patients with complaints of headache or abdominal pain in the general and pediatric EDs of the same hospital.
Methods A retrospective chart review of patients aged 15 to 18 years, who presented with headache or abdominal pain at the general and pediatric EDs of Seoul National University Hospital from January 2010 to December 2014, was conducted.
Results A total of 407 adolescent patients with complaints of headache and 980 with abdominal pain were included in this study. The adolescent patients in the general ED were more likely to undergo CT scans than those in the pediatric ED, with both patients having headache (42.4% vs. 20.5%, respectively, P<0.001) and abdominal pain (29.0% vs. 18.4%, respectively, P<0.001). There was no statistical difference in the rates of positive CT findings between the general and pediatric EDs. The frequency of visits to the general ED was associated with high rates of CT use in adolescent patients with complaints of headache (odds ratio, 3.95; 95% confidence interval, 2.01 to 7.77) and those with abdominal pain (odds ratio, 1.76; 95% confidence interval, 1.18 to 2.64).
Conclusion The ED setting influences the use of CT on adolescent patients, and a child-friendly environment could reduce the radiation risks.
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Lesson from a Single Pediatric Emergency Department: Potentially Applicable Radiation-Minimizing Practices for Non-Traumatic Abdominal Pain in Adolescents Min Kyo Chun, Reenar Yoo, Soo-young Lim, Dahyun Kim, Jeeho Han, Seung Jun Choi, Jeong-Yong Lee, Jong Seung Lee, Jun Sung Park Children.2025; 12(10): 1306. CrossRef
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Clin Exp Emerg Med 2017;4(4):208-213. Published online December 30, 2017
Objective Chest pain is one of the most common complaints in the emergency department (ED). Cardiac computed tomography angiography (CCTA) is a frequently used tool for the early triage of patients with low- to intermediate-risk acute chest pain. We present a study protocol for a multicenter prospective randomized controlled clinical trial testing the hypothesis that a low-dose CCTA protocol using prospective electrocardiogram (ECG)-triggering and limited-scan range can provide sufficient diagnostic safety for early triage of patients with acute chest pain.
Methods The trial will include 681 younger adult (aged 20 to 55) patients visiting EDs of three academic hospitals for acute chest pain or equivalent symptoms who require further evaluation to rule out acute coronary syndrome. Participants will be randomly allocated to either low-dose or conventional CCTA protocol at a 2:1 ratio. The low-dose group will undergo CCTA with prospective ECG-triggering and restricted scan range from sub-carina to heart base. The conventional protocol group will undergo CCTA with retrospective ECG-gating covering the entire chest. Patient disposition is determined based on computed tomography findings and clinical progression and all patients are followed for a month. The primary objective is to prove that the chance of experiencing any hard event within 30 days after a negative low-dose CCTA is less than 1%. The secondary objectives are comparisons of the amount of radiation exposure, ED length of stay and overall cost.
Results and Conclusion Our low-dose protocol is readily applicable to current multi-detector computed tomography devices. If this study proves its safety and efficacy, dose-reduction without purchasing of expensive newer devices would be possible.
Objective The overall use of Computed Tomography (CT) continues to grow inside the hospital. Despite CT imaging is a valuable diagnostic technique, the relatively high radiation doses associated with CT compared with conventional radiography have raised health concerns such as future cancer risk. We investigated the awareness level concerning radiation dose and possible risks associated with CT scans in medical personnel (MP).
Methods and materials: This study was conducted from April to May 2012. Physicians and nurses who worked in emergency department of 17 training hospitals were enrolled in the survey. The questionnaire included the degree of CT scan or radiography affecting health using a 10 numerical rating scale, estimation of the radiation dose for the CT scan compared with one chest radiograph, and the perception of the increased lifetime cancer risk of CT scan.
Results A total of 354 MP participated in this study. They included 142 nurses, 87 interns, 86 residents, and 39 specialists. Interns were less aware of CT scan or radiography affecting health than other physicians or nurses (4.8±2.7 vs. 5.9±2.7 vs. 6.1±2.7 vs. 6.0±2.2, interns vs. residents vs. faculties vs. nurses, respectively. mean (SD). p < 0.05). There was significant difference in the knowledge about the relative radiation dose of the CT scan for one chest radiograph between doctors and nurses (48.6% vs. 28.9%, doctors vs. nurses, p < 0.05). MPs perceived increased cancer risk from radiation of CT scan.
Conclusions Medical personnels perceived the radiation risk associated with CT scan, but seems to be insufficient.
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