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CAT (CT) Scan Overuse in Emergency Rooms

Updated on February 23, 2011

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.


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    • nickshamrock profile image

      nickshamrock 6 years ago

      "Don't tell me that its impossible to get too much radiation"

      That's precisely what I was trying to get at with this article. I've seen patients get a brain CT every day for 2 weeks, WAY too much radiation.

      However, sometimes these scans are necessary. I understand your disappointment in our healthcare system, and the overuse of our technology, but these machines do help diagnose extremely life threatening conditions, such as brain bleeds, aortic dissections, strokes, and others. In the same breathe... you don't need them every other month, or even every other year, except in extreme circumstances.

    • profile image

      me 6 years ago

      Don't know about all that...

      I was in a lethal accident 3 years ago, bled out for 8 weeks...didn't get any radiation till 2 months after... then two months after that... That first and second year I had more CT scans, MRIs and Xrays than I've had my picture taken. Every two weeks? Was that ever necessary? As a result of too much radiation too soon, the radiation locked my injuries into place, I lived in a basically dead body, 15% alive for 3 yrs, only by the grace of god did I survive. My mitochondria stopped functioning, my organs went into atrophy, sight changed, I was acting like a mentally challenged person when I'm the exact opposite...Every time of the month would be a trip to the ER for a normal person, me, I crossed my fingers and hoped to live... Because of the organs shutting down, I couldn't take any pain killers or drink like I wish I could have to ease the pain... Finally I found the right doc 3 yrs later who brought me back to life with a diet of anti-radiation homeopathic meds. They work perfectly! At the hospital, they diagnosed me with every whack thing under the sun when really I only had two problems, cranial dislocation C2 through C5 and radiation poisoning. All these tests add up!!!!!! One CT scan is 3-5xms the amount of radiation the government says is ok...if you have 3 in a year or 7 in a year that's like getting several THOUSAND xrays in a year if 1CT scan=400 xrays The thing that sucks is, and what they don't tell you unless you've had too much radiation is all your teeth explode... Yup... I had over a hundred dental repairs in 2 years root canal or tooth explosion on every tooth... some hair loss but major metal retardation, wide spread pain everywhere, total lethargy to the point of narcolepsy...couldn't process food or have bowel movements... Getting too many diagnostic tests DOES!! cause some deadly health issues that medical professionals attach any other name to besides what it really is. Like fibromylagia... you get fibroids from radiation, autonomic neuropathy, you get wide spread pain from your organs going into atrophy because of the change in the bodies chemistry from radiation, orthostatic intolerance meaning blood stops circulating correctly so you start blacking out and can't get air... also caused by the effects of radiation on the heart...violent continuous vomitting also a sure sign...

      When that code was cracked, that I had radiation and not all this other bs..,. I got right up and started rollarblading like I was never ill... with a Miami J neck brace on as an exoskeleton to protect C2-C5 while they recover but still, I'm doing 10 mile a day sessions racing cars!! with my antiradiation bug juice...I got my mojo back broken neck and all!! Don't tell me that its impossible to get too much radiation, anyone who says so is not so smart as they think. If I hadn't found that doc in the nick of time, I'd be dead, instead of chatting here on this page. No thank you ER you suck! Never again!! I'd rather fly to china and go nonwestern med, next catastrophe(hopefully never)!

    • Ralph Deeds profile image

      Ralph Deeds 8 years ago from Birmingham, Michigan

      There was an excellent series of articles on CT Scan overuse and horrible errors in the NY Times last month. You have put your finger on an important issue.