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Published on April 14, 2011

Kish Addresses CT Scans for Children

April 14, 2011

To the editor:

On April 5, the Daily Chronicle published an AP wire service story about the rising number of children getting CT scans in emergency rooms, raising concerns about their exposure to adult –level radiation doses and potential risks for cancer down the road.

The study was led by Dr. David Larson at Cincinnati Children’s Hospital Medical Center and was just published in the journal Radiology.

The radiologists and ER doctors at Kishwaukee Community Hospital share the concern of Dr. Larson and his colleagues regarding the increasing use of CT in children seen in emergency departments throughout the U.S. over the past 15 years.  Among other factors, this rise can be attributed to significant improvements in the technique and the wealth of clinical information CT exams can quickly provide in the evaluation of the acutely ill child.  
However, as children are especially vulnerable to the potential detrimental effects of ionizing radiation, one must be diligent both in specialty children's hospitals as well as in community hospitals such as Kish, to ensure that these exams are requested and performed judiciously and optimized to minimize potential risk while maintaining diagnostic quality.

When children present to the Emergency Room with complaints that may require a CT, their history and physical exam, along with the risks of radiation exposure, are taken into consideration before ordering the CT. 

We have seen an increase in parent awareness of the risks, resulting in a better understanding when the ER physician feels the scan is not necessary given the child’s symptoms and other contributing factors.

At Kish, the Diagnostic Imaging Department has been using specially adjusted CT protocols in children, as well as adults, for many years, in accordance with ALARA (radiation dose As Low As Reasonably Achievable) recommendations and more recent radiation dose reduction efforts specific to the pediatric population, including the national Image Gently campaign, launched in 2008. 

For all patients and especially children, we also use bismuth shields to reduce the dosage received by the patient's optic lenses, thyroid gland, and breasts by up to 50 percent. These shields help protect the more radiosensitive body parts from the ionizing effects of radiation and yet do not diminish the diagnostic efficacy of the ct scans.

In addition, the Radiologists and ER physicians work in consort to determine if another type of imaging test that does not use radiation is appropriate for a child, such as ultrasound evaluation of children with suspected acute appendicitis.

The Kish Hospital medical staff is committed to excellence in patient care and safety, and we continue to monitor our own local trends and employ technical advances and improvements to our processes toward that goal.

Dr. James Lee
Radiology Medical Director

Dr. Andrew Oleksyn
Emergency Department Medical Director
Kishwaukee Community Hospital

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