Browne, Marybeth, MD

Crowder, Carly

Geist, Heather

Iobst, Taylor

Thatch, Keith A, MD

Zimel, Catherine

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksResearch Scholars Poster PresentationStop the Radiation! Decreasing CT ScanUtilization in Pediatric Trauma PatientsCatherine ZimelTaylor IobstGeorge Mason University, Taylor.Iobst@lvhn.orgCarly CrowderLehigh Valley Health Network, carly.crowder@lvhn.orgHeather Geistheather.geist@lvhn.orgKeith A. Thatch MDLehigh Valley Health Network, Keith_A.Thatch@lvhn.orgSee next page for additional authorsFollow this and additional works at: https://scholarlyworks.lvhn.org/research-scholars-postersThis Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtZimel, C., Crowder, C., Iobst, T., Geist, H., Thatch, K., Browne, MB. (2016, July, 29) Stop the Radiation! Decreasing CT scan utilizationin pediatric trauma patients. Poster presented at LVHN Research Scholar Program Poster Session, Lehigh Valley Health Network,Allentown, PA.AuthorsCatherine Zimel, Taylor Iobst, Carly Crowder, Heather Geist, Keith A. Thatch MD, and Marybeth BrowneMDThis poster is available at LVHN Scholarly Works: https://scholarlyworks.lvhn.org/research-scholars-posters/475© 2016 Lehigh Valley Health NetworkLehigh Valley Health Network, Allentown, PennsylvaniaStop the Radiation! Decreasing CT scan utilization in pediatric trauma patientsHoffman, J. R., Mower, W. R., Wolfson, A. B., Todd, K. H., & Zucker, M. I. (2000). Validity of a Set of Clinical Criteria to Rule Out Injury to the Cervical Spine in Patients with Blunt Trauma. New England Journal of Medicine N Engl J Med,343(2), 94-99.Kreykes, N. S., & Letton, R. W. (2010). Current issues in the diagnosis of pediatric cervical spine injury. Seminars in Pediatric Surgery, 19(4), 257-264. Markel, T. A., Kumar, R., Koontz, N. A., Scherer, L. R., & Applegate, K. E. (2009). The Utility of Computed Tomography as a Screening Tool for the Evaluation of Pediatric Blunt Chest Trauma. The Journal of Trauma: Injury, Infection, and Critical Care, 67(1), 23-28.• We increased our level of appropriateness for c-spine and chest CT scans post-education.• There was a dramatic decrease in patients who got chest CT scans.• Only 1/39 patients had a possible clinically relevant injury on their chest CT after a normal chest x-ray.• Education alone does not significantly improve quality of care– additional clinical quality review is vital to improving outcomes.• Retrospective data analysis – Used LVHN trauma database for June-August of the years 2013-2015.– H&P, radiological images, and clinical guidelines were used to assess appropriateness of scans.• Patient selection– Age 15 or younger– Trauma Alerts & Code Reds– N=87 patients for cervical spine data– N=97 patients for chest data• Exclusion Criteria– Excluded from the c-spine and chest data if they did not have an H&P on file.• Expanding review to include entire year’s data• Additional review of head and abdominal CT scan utilization• Finalizing implementation of our c-spine utilitzation guidelines Catherine Zimel, Carly Crowder, Taylor Iobst, Heather Geist, Keith Thatch MD, Marybeth Browne MDDepartment of Surgery, Division of Pediatric SurgeryBACKGROUND / INTRODUCTIONMETHODSRESULTS DISCUSSIONFUTURE WORK• In 2013, LVH underwent a pediatric trauma site review and was found to overutilize CT scans in our pediatric trauma patients. • A quality initiative was then developed in 2014 which included education for nurses and physicians on CT use and its appropriate indications. This reduction strategy was continued in 2015 with the addition of intense case review and discussion. • The purpose of this project is to assess the impact of our QI intitative on CT utilization.75% 75%50% 50%80%90%0%10%20%30%40%50%60%70%80%90%100%Appropriate CTaccording to criteriaAppropriate CTaccording to qualityreviewPercentage of PatientsCervical Spine CT Imaging2013 2014 2015Figure 1: Analysis of Pediatric Trauma C-Spine DataFigure 2: Analysis of Pediatric Trauma Chest Data3/4 3/42/42/48/109/1054%21.4%44.4% 41.6%29.5%46.2%0%10%20%30%40%50%60%70%Patients who got CT Appropriate CTaccording to qualityreviewPercentage of PatientsChest CT Imaging2013 2014 201514/2612/2713/443/145/12 6/13

Stop the Radiation! Decreasing CT Scan Utilization in Pediatric Trauma Patients

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Stop the Radiation! Decreasing CT Scan Utilization in Pediatric Trauma Patients

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