Emergency Room Visit Equivalent to Over 1000 X-rays

Researchers in North Carolina reported Monday that emergency room patients receive the equivalent of 1,005 chest x-rays, enough radiation to increase their risk of cancer.

The researchers called on doctors to rethink whether or not such high doses of radiation are necessary for these patients, particular the younger ones. 

The researcher team, led by Dr. James Winslow of Wake Forest University in North Carolina, analyzed medical records from 86 patients who visited a level-one trauma center during 3 months in 2006.  Over half the patients had been in car accidents.

The analysis revealed that the patients received many X-rays and computed tomography or CT scans, which provide better images but deliver higher amounts of radiation.

"Multi-trauma patients are at high risk of life-threatening injuries, which clearly justifies aggressive testing to determine the best course of treatment using all the tools available in the emergency department," Winslow said in a Reuters report.

"However, physicians should consider the long-term risks and benefits of exposing their patients to the high levels of radiation emitted by the series of studies informally referred to as the ‘pan scan,’ or computed tomography of the head, neck, chest, abdomen and pelvis."

It has long been known that X-rays increase the risk of cancer, and that this risk corresponds to cumulative lifetime radiation exposure.   The risk is higher for younger people since they have more years ahead of them in which to develop a tumor.

Winslow and his team said the average person living in the United States receives about 3 millisieverts of background radiation every year.    However, the trauma patients received on average 40 millisieverts, the equivalent of over 13 years exposure to background radiation.

"Possible options for reducing radiation exposure may include ordering fewer repeated imaging studies, using lower dose radiological imaging techniques and using alternative imaging methods that do not use radiation, such as ultrasound and magnetic resonance imaging,” Winslow said.

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Winslow’s study was published in the journal Annals of Emergency Medicine. The full report can be viewed at http://www.annemergmed.com/webfiles/images/journals/ymem/jewinslow.pdf.