02290nas a2200205   4500000000100000008004100001100001800042700001600060700001200076700001300088700001300101700001800114700001000132245014900142250001500291300001000306490000700316520171500323020004602038       2012                            d1 aTaylor Colman1 aCurtis Kate1 aAsha S.1 aGrant N.1 aSmart R.1 aCompagnoni K.1 aLo S.00aComparison of radiation exposure of trauma patients from diagnostic radiology procedures before and after the introduction of a panscan protocol  a2012/02/09  a43-510 v243 a<p>
Objectives: To compare the proportion of patients exposed to a radiation dose in excess of 20 mSv, and to document missed injuries before and after the introduction of a panscan protocol for blunt trauma. Methods: Data were collected retrospectively from our trauma database for 6 months before and after implementation of the protocol. All radiological studies performed during the initial patient assessment were identified. Radiation doses for each patient were calculated. Subgroup analyses were age <!--=30 and -->30 years, injury severity score (ISS) &lt;16 and &gt;/=16, and patient disposition as discharged from ED or admitted. Results: There were 656 patients before and 624 after the introduction of the protocol. The proportion of patients exposed to a radiation dose &gt;20 mSv increased by 8% (95% confidence interval [CI] 4-12), which equated to one extra person being exposed to &gt;20 mSv for every 13 patients treated after the introduction of the protocol. The odds of receiving a radiation dose &gt;20 mSv after the introduction of the protocol compared with the odds before were increased across all subgroups (<!--=30 years: odds ratio [OR] 2.7, 95% CI 1.3-5.8, P = 0.008; -->30 years: OR 2.2, 95% CI 1.5-3.4, P &lt; 0.001; ISS &lt; 16: OR 2.4, 95% CI 1.5-3.9, P &lt; 0.001; ISS &gt;/= 16: OR 2.0, 95% CI 1.0-3.7, P = 0.04; discharged home: OR 2.1, 95% CI 0.7-6.0, P = 0.17; admitted: OR 2.2, 95% CI 1.5-3.3, P &lt; 0.001). There were six missed injuries before and four after. Conclusions: Introduction of a panscan protocol increased the proportion of trauma patients receiving a radiation dose &gt;20 mSv. This increased risk occurred regardless of age or injury severity.
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