I’ve attended to more than one paediatric fall where parents or guardians have an expectation that their charge will be taken “for a scan” upon arrival at hospital (as seen on TV*).
The same parents or guardians are subsequently reassured if you are able to explain that this might not happen, unless there is a very very good reason to do so, given that emergency physicians try to avoid exposing kids to radiation unnecessarily.
But how much radiation are we talking, and what are the risks ?
Here’s a great post from Robert Cloutier at Academic Life in Emergency Medicine (ALiEM) which steps you through the radiation numbers and projected risks;
I think it’s good to know that a single CT can the the equivalent of hundreds of plain film X-ray images.
For some more detail on dosing in the adult population, you’ll find a handy summary table here;
*Television has a lot to answer for..
If you’ve been having a robust discussion about spinal immobilisation of patients with ‘mechanism’ recently, you’ll find this summary from EM Docs very useful for addressing the arguments which keep coming up;
(I’m yet to encounter a conscious patient with altered sensation or deficits who hasn’t self-protected their spine)
More discussion around risk, immobilisation and collars;
Big in Norway / makes sense.. It’s my preferred position for any unconscious patient who has no risk of spinal injury;
Times are a changing – a discussion of the conflict between the existing C-spine rules from the Boring EM folks.
I think we will experience a re-think of C-spine management in the coming years..