Radiation Exposure in Patients with Multiple Trauma in Level 2 and 3 Triage During first 48 Hours of Admission; a Cross-Sectional Study
Introduction: Recently, radiological imaging could be help to diagnose injury in the patients with multiple trauma in the emergency department (ED). Objective: In this study, we aimed to compare the radiation exposure within 48 hours, in patients with multiple trauma in level 2 and 3 triage admitted to ED. Method: This cross-sectional study was conducted on patients with multiple trauma of Level 2 and 3 triage who were referred during 2014-2015 to the EDs of Imam Khomeini Hospital of Tehran and Alzahra hospital of Isfahan, Iran. Radiation exposure of radiographies and computed tomography (CT) scans in patients were calculated during the first 48 hours of admission. Results: In this study, 220 patients with the mean age of 35.41±15.04 years were studied of whom 120 patients (54.5%) were male. The mean radiation exposure was 3.43±3.12 mSv. The mean radiation exposure of CT-scan in level 2 was significantly higher than level 3 (p<0.001). On the other hand, the mean radiation exposure of radiography in level 3 was significantly higher than level 2 (p=0.022). Also, the mean radiation exposure of total radiation in level 2 was significantly higher than level 3 (p<0.001). Conclusion: In 48 hours admitting to emergency department, patients with multiple trauma in Level 2 had more radiation exposure than Level 3.
2. ITLS. International Trauma Life Support for Emergency Care Providers, Global Edition: Pearson Education Limited; 2017.
3. Jones CMC, Cushman JT, Lerner EB, Fisher SG, Seplaki CL, Veazie PJ, et al. Prehospital trauma triage decision-making: a model of what happens between the 9-1-1 call and the hospital. Prehosp Emerg Care. 2016;20(1):6-14.
4. Miele V, Piccolo CL, Trinci M, Galluzzo M, Ianniello S, Brunese L. Diagnostic imaging of blunt abdominal trauma in pediatric patients. Radiol Med. 2016 May;121(5):409-30.
5. Shore RE, Moseson M, Xue X, Tse Y, Harley N, Pasternack BS. Skin cancer after X-ray treatment for scalp ringworm. Radiat Res. 2002 Apr;157(4):410-8.
6. Kortbeek JB, Al Turki SA, Ali J, Antoine JA, Bouillon B, Brasel K, et al. Advanced trauma life support, the evidence for change. J Trauma. 2008 Jun;64(6):1638-50.
7. Amis Jr ES, Butler PF, Applegate KE, Birnbaum SB, Brateman LF, Hevezi JM, et al. American College of Radiology white paper on radiation dose in medicine. J Am Coll Radiol. 2007 May;4(5):272-84.
8. You JS, Lee H-J, Chung YE, Lee HS, Kim MJ, Chung SP, et al. Diagnostic radiation exposure of injury patients in the emergency department: a cross-sectional large scaled study. PloS one. 2013;8(12):e84870.
9. Schears RM, Farzal Z, Farzal Z, Fischer AC. The radiation footprint on the pediatric trauma patient. Int J Emerg Med. 2018 Mar 14;11(1):18.
10. Giannakopoulos G, Saltzherr T, Beenen L, Streekstra G, Reitsma J, Bloemers F, et al. Radiological findings and radiation exposure during trauma workup in a cohort of 1124 level 1 trauma patients. Langenbecks Arch Surg. 2017 Feb;402(1):159-165.
11. Tien HC, Tremblay LN, Rizoli SB, Gelberg J, Spencer F, Caldwell C, et al. Radiation exposure from diagnostic imaging in severely injured trauma patients. J Trauma. 2007;62(1):151-6.
12. Winslow JE, Hinshaw JW, Hughes MJ, Williams RC, Bozeman WP. Quantitative assessment of diagnostic radiation doses in adult blunt trauma patients. Ann Emerg Med. 2008;52(2):93-7.
13. Einstein AJ, Henzlova MJ, Rajagopalan S. Estimating risk of cancer associated with radiation exposure from 64-slice computed tomography coronary angiography. JAMA. 2007;298(3):317-23.
14. Boffard KD, Goosen J, Plani F, Degiannis E, Potgieter H. The use of low dosage X-ray (Lodox/Statscan) in major trauma: comparison between low dose X-ray and conventional X-ray techniques. J Trauma. 2006;60(6):1175-83.
15. Brenner DJ, Elliston CD, Hall EJ, Berdon WE. Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR Am J Roentgenol. 2001;176(2):289-96.
16. Brenner DJ, Doll R, Goodhead DT, Hall EJ, Land CE, Little JB, et al. Cancer risks attributable to low doses of ionizing radiation: assessing what we really know. Proc Natl Acad Sci U S A. 2003 Nov 25;100(24):13761-6.
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