Safely Reducing Unnecessary Imaging in the Pediatric Trauma Patient
Kellie Girardot, MSN, RN
Parkview Regional Medical Center, Fort Wayne, IN
BACKGROUND
In non-pediatric facilities, pediatric trauma patients get an increased number of computed tomography (CT) scans, many of which are not necessary. This leads to radiation exposure for which children are ten times more sensitive than adults. In order to safely reduce unnecessary imaging of pediatric trauma patients, evaluation of the use of CT scanning among a low risk group was compared at a Level II Pediatric Trauma Center.
METHODS
The population included all patients evaluated by the trauma team who were less than 16 years of age with a Glasgow Coma Score (GCS) of 14 or 15. A cervical spine CT scanning rate was calculated using the number of patients who had a CT at the trauma center divided by the number of all patients in the group evaluated by the trauma team. The interventions included development and implementation of a cervical spine CT guideline followed by monthly review of CT scanning appropriateness.
RESULTS
The baseline rate of cervical spine CT in pediatric trauma was 37.4% (fiscal year 2015), and the current rate is 22.5% (fiscal year 2018, quarter 1 and 2). There have been no missed injuries of the cervical spine since the start of this project.
CONCLUSION
The rate of cervical spine CT has been safely reduced by 14.9% in pediatric trauma patients.
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