Pediatric dose protocols widespread for head CT

The majority of community hospitals in the U.S. have pediatric dose reduction protocols for head CT, though there is some variation based on hospital characteristics and also differences in the utilization of protective shielding, according to a study published in the July issue of the Journal of the American College of Radiology.

“The wide adoption of these practices suggested high awareness of the importance of mitigating radiation exposure among young injured patients,” wrote Janessa M. Graves, PhD, MPH, of the Harborview Injury Prevention and Research Center at the University of Washington in Seattle, and colleagues. They specifically cited the Image Gently campaign, which launched in 2008, as one the programs educating healthcare providers and parents on the importance of radiation dose reduction.

To get a picture of how many community hospitals around the country have pediatric dose reduction protocols for head CT, Graves and colleagues sent surveys to 751 hospitals. A total of 253 eligible hospitals replied.

Results showed that 92.6 percent of the hospitals reported using a pediatric dose reduction protocol. Hospitals of less than 50 beds were 20 percent less likely to use a protocol than hospitals greater than 150 beds. Teaching hospitals were also more likely to report using a protocol, according to the authors.

“The presence of a training program may correlate with increased awareness of pediatric radiology safety issues, which contributed to the increased likelihood of teaching hospitals reporting protocol use in this study,” wrote Graves and colleagues.

Protective shielding use was high at 70 percent, but somewhat counterintuitively, children’s hospitals were 36 percent less likely to report using protective shielding than nonchildren’s hospitals. Graves and colleagues suggested this is likely due to the scanner types used. Automatic tube current modulation does not require shielding, and it’s possible more advanced scanners at children’s hospitals did not necessitate shielding.

“National efforts like Image Gently, collaborative guidelines for appropriate CT use that apply to multiple specialties, and national publication of optimized CT protocols, such as those produced by the American Association of Physicists of Medicine, should continue to maintain the current high level of adoption of patient safety practices,” wrote Graves and colleagues.