Effective radiation dose received by severely injured trauma patients during emergency investigations

Abstract

Background Assessment of severely injured (P1) trauma patients include extensive investigation of all the injuries sustained. The reason for this is to reach proper diagnosis and minimise the risk of missing injuries, some of which might have grave outcomes. As a result a battery of tests are ordered during their admission to the emergency department (ED). Amongst the investigations conducted are radiological studies that invariably expose these patients to radiation with its possible complications. In our setting these include Lodox, X-rays & Computed tomography (CT) scans. In this study we quantitatively estimated the amount of radiation received by P1 trauma patients during their admission to ED.

Materials and Methods A retrospective, HREC approved study was conducted. The data collected included P1 patients, over the age of eighteen, admitted to CMJAH trauma ED over a period of six months. The primary end point was to estimate the amount of radiation received by these patients during radiological investigations. The amount of radiation received was also compared according to mode of injury sustained.

Results Out of the 6623 patients seen in CMJAH ED during the six month period of the study, only 1173 patients met all the inclusion criteria. P1 trauma patients received a considerable amount of radiation during their admission to ED. CT scans were responsible for most of the radiation received. On the other hand Lodox exposed patients to the least amount of radiation. Patients with blunt trauma received more radiation compared with patients with penetrating trauma.

Conclusion Radiological investigations expose P1 trauma patients to considerable amount of radiation. Requesting these investigations, critical as they may be in the management of severely injured trauma patients, must be done with full cognizance of the amount of radiation they impose on these patients. Lodox, because of its low radiation and its ability to scan the whole body, makes it a favourable equipment to have in an emergency department. Focused X-rays can then be done as suggested by findings from the lodox, collarating this with the clinical picture of the patient.