Physician Groups Join Forces to Improve Use of Head CT Scans in Children

WASHINGTON, Nov. 2, 2016 /PRNewswire-USNewswire/ -- The Image Gently Alliance, American Academy of Pediatrics (AAP), American College of Emergency Physicians (ACEP), AANS/CNS Joint Section on Pediatric Neurosurgery and allied medical organizations have launched the "Think A-Head" campaign to help providers appropriately obtain and perform computed tomography (CT) scans in children with minor head injuries. The effort will also equip providers and parents with resources to help them communicate effectively when CT scans may (or may not) be the best option to gain proper diagnosis.

The "Think A-Head" campaign provides tools and resources to:

• Help providers ensure ordering patterns comply with latest evidence-based medical guidelines
• Help providers explain to parents/caregivers why an imaging scan is (or is not) necessary
• Help parents ask questions to better inform decision making if their child is prescribed a head CT scan
• Help imaging professionals use appropriate exam radiation dose

"This collaboration is a tremendous opportunity to ensure that providers have the latest information on which to base their medical decisions, that parents can take an active, informed role in advocating for their child's health care, and that children receive the most appropriate care for their medical situation," said Donald Frush, MD, chair of the Image Gently Alliance and Image Gently liaison to the International Atomic Energy Agency (IAEA).

Physicians – If kids hurt their heads, help families make informed decisions:

• Know when an imaging test is (and is not) necessary
• Explain why a head CT scan is (or is not) the right choice
• Discuss possible alternative exams
• Discuss the benefits as well as the risks of the CT scan
• Child-size the CT radiation dose (where necessary)

"Children requiring emergency care have unique needs. Providers must quickly consider the benefit of scans versus the potential risk, the wishes of the parents and severity of injury. This campaign helps us provide more readily available resources to help emergency providers balance and communicate these factors and provide timely and appropriate care," said Madeline M. Joseph, MD, FACEP, chair of the American College of Emergency Physicians Pediatric Emergency Medicine Committee.

Parents – Be your child's advocate: Ask these questions if your child is prescribed a head CT scan:

• How will this exam improve my child's care?
• What are the benefits and risks of having this test?
• What will my child experience before, during and after the exam?
• Are there alternative tests that don't use radiation (such as brain MRI)?
• Will the radiation dose in this exam be "child sized"?

"CT scans are a powerful tool to speed diagnosis of potentially life-threatening conditions, but not every situation calls for a CT scan. The tools available through this campaign help doctors and patients communicate the best course of action for a child's condition and work together to ensure each child gets the best possible care," said Charles Macias, MD MPH, chair of the American Academy of Pediatrics Section on Emergency Medicine. 

Imaging Providers – When performing imaging CT exams:

• Optimize, or "child-size," the amount of radiation used
• Do not over-scan:
  • Scan only when necessary
  • Scan only the indicated region
  • Scan once; multiphase scanning (pre-and post-contrast, delayed exams) is rarely helpful
• Be a team player:
  • Involve medical physicists to review pediatric CT techniques
  • Involve technologists to optimize scanning

"CT technologists are on the front lines of patient care and play a crucial role in making sure all patients receive the best care possible," said Mike Latimer, M.S.R.S., R.T.(R), president of the American Society of Radiologic Technologists. "The Think A-Head campaign adds to the profession's body of knowledge and offers significant resources to further improve patient care."

"Medical physicists are key to ensuring that imaging equipment, especially CT, is installed and operates properly so that the appropriate dose can be delivered to ensure quality images are delivered to enable physicians to make the right diagnosis. This is important when imaging children. AAPM remains a firm supporter of the Image Gently campaign and believes that "Think A-Head" campaign will make a difference in ensuring quality medical care for all patients especially children," stated President-elect Melissa Martin, FAAPM, FACR, FACMP.

The Image Gently Alliance website (imagegently.org) contains the latest research and educational materials to aid radiologists, radiologic technologists, medical physicists and other imaging stakeholders in determining the appropriate radiation techniques to be used in the imaging of children and how the radiation received from these exams may affect pediatric patients over time. Health care providers are urged to visit the Image Gently site and pledge to do their part to image gently. Image Gently also offers resources for parents (imagegentlyparents.org) about pediatric imaging (including frequently asked questions).

SOURCE American College of Radiology

Related Links

http://www.acr.org