"We found there was no correlation between the severity of injury and when a CT was performed," says Jennifer Marin about a review of 81,000 cases of injured children treated at 14 emergency departments. (Credit: iStockphoto)

children's health

How do doctors decide when kids need CT scans?

Emergency departments vary widely when it comes to ordering CT scans for children, a new study shows, but establishing best-practice guidelines might protect them from unnecessary radiation exposure.

There is growing concern that young patients may be exposed to harmful levels of radiation from CT scans, says Jennifer Marin, assistant professor of pediatrics and emergency medicine at the University of Pittsburgh School of Medicine.

“Injuries are the leading cause of death in children, and CT is the most accurate method we currently have available to diagnose many of these injuries. We wanted to evaluate if and to what degree CT use varied for injured children seen in the emergency department. We found there was no correlation between the severity of injury and when a CT was performed.”

For the study, published in the Journal of Pediatrics, researchers looked back at nearly 81,000 cases of injured children treated at 14 emergency departments (ED) from November 2010 to February 2013. More than 98 percent had minor injuries and were discharged to home.

[CT scans better at spotting clogged arteries]

Doctors were more likely to order CT scans for intracranial injuries, skull and spine fractures. Of those visits in which a CT was performed, 28 percent were associated with more than one CT, 8 percent were associated with more than two CTs, and in some cases, up to 7 CT scans were performed.

“Emergency rooms vary widely in their use of CT scanning with some more likely to perform CT scanning than others,” Marin says. “Additionally, some are more likely to use specific types of CTs, such as cervical spine and chest CTs, which is noteworthy, given the radiation dose and radiosensitive areas like the pediatric thyroid and breast being exposed.”

The study was not designed to look at patient outcomes or the appropriateness of CT use, Marin says.

Other researchers from the University of Pittsburgh and Boston Children’s Hospital contributed to the study. The National Institutes of Health funded the work.

Source: University of Pittsburgh

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