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Comparison of Image Related Radiation Exposure in Pediatric Trauma Patients Evaluated at Pediatric Trauma Centers versus Non-Pediatric Trauma Centers
Taylor L. Derr, BS, E. Brooke Lerner, PhD, David M. Gourlay, MD. Medical College of Wisconsin, Milwaukee, WI, USA.

Background: We compared CT use in pediatric trauma patients treated at pediatric trauma centers (PTC) versus non-PTC. Specifically comparing the amount of radiation patients received during initial evaluation.

Methods: A retrospective review was conducted of all blunt trauma patients that received CT imaging and were admitted to a level 1 PTC from 2013 to 2014. A chart review was performed to determine type of CT and radiation exposure. Mean radiation at each hospital type was compared using t-test.

Results: 452 patients were identified of which 237 (52.4%) were initially evaluated at a PTC while 215 (47.6%) were transferred from non-PTC. These two cohorts were similar in demographics and severity. More head, c-spine, and chest/abdomen/pelvis CTs were conducted at non-PTC (Table 1). CTs at non-PTC, on average, had higher radiation exposure except for abdomen/pelvis CTs. No CTs at PTC surpassed ACR's Pass/Fail accreditation criteria while 10 (6.29%) studies at non-PTC did not meet ACR's standards. Finally, 35% of patients at non-PTC had CTs in multiple areas while only 22% had multiple CTs at the PTC.

Conclusions: Pediatric patients evaluated at non-PTC undergo more CT imaging and are exposed to more radiation for their initial evaluation of blunt trauma. While most patients' radiation did not exceed the American College of Radiology (ACR) maximum radiation dose there is still considerable higher radiation exposure at non-PTC compared to PTC.

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