CAT (CT) Scan Overuse in Emergency Rooms
Are you being over-radiated?
Radiation exposure is not something people think about every day. That is, unless you’re a radiology tech or someone who works in the field of radiation. These days, people are getting exposed to far more radiation during medical visits than necessary.
During a trip to the hospital, you can expect quite a few tests to be run. Blood work, a chest X-ray, and possibly a CT Scan. Emergency room physicians are using CT Scans (Computer Tomography or CAT Scans) more and more frequently to help diagnose and treat patients. They like them because they are very quick, they are more detailed than a standard X-Ray, and they are relatively inexpensive compared to an MRI. A CT Scan of the brain can take between 2-5 minutes, and an abdomen and pelvis scan can take about 10.
CT imaging is a vast improvement over standard X-Rays, but the radiation exposure is much higher. The great irony is that in an attempt to diagnose cancer, the scan itself may be causing it.
It has been proven in multiple studies, though professionals disagree on what studies on radiation actually show, but they do know radiation can cause cancer. Most will agree that the benefits of having a scan will outweigh the risk. Which is true, but only on a case by case basis. In some hospitals, there are patients that practically live in the emergency room. Some are drug seekers, and some are just people who are very sick. Patients, and mostly hypochondriacs (people who feel minor abnormalities are serious conditions, despite reassurance by physicians) want proof that they are fine. The only way that doctors can prove this is by showing them pictures and lab results.
Another reason why doctors will order so many CT Scans is because of the speed in which they can be done. If a patient comes in for a minor head injury or headache, it is easy to get them a CT Scan and send them home when everything is normal. That way they can tend to the real emergent cases such as heart attacks, stroke victims, and major trauma cases.
CT Scans are about the equivalent of at least 50 X-rays. Some can be compared to 400 X-Rays. Proper shielding for the scans are still unknown. Some physicists say that if you shield a patient, you could expose them to more radiation. The scanner has a few “cameras” in it that circle around the patient taking picture after picture. Some say that if you place a shield over top of a patient, the radiation will go through the patient, bounce off the lead and go back through the patient where it is absorbed again. There have not been enough studies to show if this is accurate, but shielding a patient is the widely accepted protocol in most hospitals.
The main culprit in the overuse of the CT Scan is the emergency room. Nobody can really blame them, as it’s necessary to use them. People need to educate themselves. They need to ask questions to the emergency room physician or their nurse. Do not wait until you’re on a CT table getting ready to have the procedure. The technologist can’t do much. They will and should always side with the physician and nurse. Your nurse is your advocator! Some questions to ask are “Is there an alternative?” or “Do you feel this is absolutely necessary?” 9 times out of 10, it really is. If someone has been having abnormal headaches, seizures, trauma, dizziness, change in mental status, or swelling, that is justifiable for a brain scan. They can be used to detect brain tumors, cysts, bleeding, strokes, aneurysms, swelling, fractures, and fluid in the head. However, there are other tests available to detect most problems that a CT Scan can. An example is kidney stones. If the doctor thinks you have a stone, an ultrasound may be able to detect it. The same with appendicitis. Or a blood clot in the lungs (a pulmonary embolism) can be detected by a VQ Scan (a nuclear medicine study). Doctors do not like VQ scans because they show the probability of a blood clot rather than if one actually exists, but if there is a high probability, the CT scan could be done afterwards to verify.
Do not let this article talk you out of visiting the emergency room. Definitely do not let it talk you out of getting a CT Scan. Educate yourself now before you have to make the trip to the ER. Also, take into consideration that the best treatment you will get is from your family physician. He or she knows your medical history. They take personal care of you. They know what is best for you and they don’t have 30 other patients rushing them around in a hurry. If a patient is having minor symptoms, they should call their family doctor. They will give advice and even refer them to the emergency room if it is needed.