Radiation exposure in trauma patients

Background: Trauma patients are exposed to a large amount of ionizing radiation. Radiologic examinations may include a multitude of plain films, computed tomography scans, and/or fluoroscopic examination. Previous studies have assessed radiation exposure to staff members at trauma centers, and in pregnant trauma patients. The purpose of the current study is to evaluate the amount of radiation to which trauma patients are exposed in a Level I trauma center. Methods: The study used a prospective cohort design. All patients for whom a trauma code was activated between the months of September 2004 and July of 2005 were eligible to be enrolled in the study. Upon arrival to the trauma bay, a dosimeter badge, that measures ionizing radiation, was attached to a Velcro bracelet on the wrist of the patient. The badges were removed at the time of discharge from the hospital and analyzed. Results: Data were collected on 224 patients (167 adults, 57 pediatric). The median amount of radiation exposure to all patients equaled 68 MREM (Interquartile range 31-181). A significant increase in the median amount of radiation exposure was found in patients with orthopedic injuries (107 MREM vs. 45 MREM), an Injury Severity Score (ISS) > 15 (107 MREM vs. 46 MREM), a length of stay > than 1 week (105 MREM vs. 65 MREM), age > 18 (82 MREM vs. 44 MREM), and when > 11 radiologic procedures were performed (127 MREM vs. 46 MREM). Conclusion: Trauma patients are being exposed to high amounts of radiation. Patients with orthopedic injuries, and those more severely injured, are at an increased risk. Further precautions to limit radiation exposure in this population are needed.