Background/introduction
A useful radiological examination is one in which the result will alter the management of the patient (Flak and Rowley,
1993).
Average radiation dose for a plain film of abdomen (PFA) = 35 times that of a CXR and equivalent to 4 months’ background radiation (RCR guidelines,
2003)
In 1964,
only 7% of PFAs were diagnostic for patients with undifferentiated abdominal pain (Rosenbaum et al,
1964)
Acceptable referral criteria for PFA in out hospital (agreed with Emergency dept.
[ED] in 2010) are: ? perforation,
?...
Description of activity and work performed
Audits of PFA requests from the ED were performed for the same 4-month period (January-April) in 2011,
2016 and 2018
Data collected included patient age,
gender,
clinical indications given for request,
report of image,
any further imaging performed and outcome
An educational programme about appropriate use of PFAs was initiated after the 2011 audit,
for radiographers,
ED doctors & other referring doctors
Justification of PFA requests was based on whether or not they met the agreed referral standards (described in Introduction),
based on Royal College...
Conclusion and recommendations
In 2011,
our audit showed that 61% of PFAs requested and obtained in the Emergency Dept.
(ED) did not meet appropriateagreed referral criteria
Subsequent to this finding,
an educational programme for referrers was initiated,
to inform them about appropriate referral criteria for PFAs,
and those indications for which PFAs should not be requested.
This programme has been continued since 2012
The positive impact of this eucational programme has been confirmed by two subsequent re-audits,
in 2016 & 2018
In 2016,
there was a reduction in...
Personal/organisational information
Adrian Brady,
Consultant Radiologist
Bridget MacAuley,
Clinical Specialist Radiographer
Sineád O'Sullivan,
doctor in training
All at:
Radiology Dept.,
Mercy University Hospital (Figs 4 & 5),
Grenville Place,
Cork T12 WE28,
Ireland
References
Flak B,
Rowley VA.
Acute abdomen:pain film utilization and analysis.
Can Assoc Radiol J 1993;44:423-428
Royal College of Radiologists.
Making the best use of a department of Clinical Radiology.
Guidelines for doctors.
4th.
ed.,
London,
1998
Rosenbaum HD,
Lieber A,
Hanson et al.
Routine survey roentgenogram of abdomen on 500 consecutive patietns over 40.
Am J Roentgenol Radium Ther Nuc Med 1964;91:903-991
Yamamoto,
Kharay.
Changing imaging practice with the emergency department: abdominal radiography - indicated but barely useful.
RSNA 2011,
LL-QSE 30302-MOA
Ahn SH,
Mayo...