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Yenidoğan Yoğun Bakım Ünitelerinde Radyografi Çekimi: Ne kadar doğru uygulanıyor?

Yıl 2021, Cilt: 18 Sayı: 3, 883 - 887, 25.09.2021
https://doi.org/10.38136/jgon.858753

Öz

Amaç: Yenidoğan Yoğun Bakım Ünitelerinde (YDYBU) radyasyon güvenliği hem hastalar hem de personel için önemli bir sorundur. Bu çalışmada üçüncü basamak bir çocuk hastanesinin YDYBU’nda gerçekleştirilen portable grafiler kalite yönünden değerlendirilecek, aynı zamanda personelin radyasyon maruziyeti hakkında da bilgi edinilecektir. Bu çalışma ile YDYBU’larda radyasyon güvenliği konusunda farkındalık oluşturmak da hedeflenmektedir.
Yöntem: 2017-2019 yılları arasında TDYBU’da gerçekleştirilen portable grafiler retrospektif olarak incelenecektir. Grafiler uygun hasta pozisyonu, uygun kolimasyon (yalnızca istenilen bölgenin görüntülenmesi, kafa ve gonad korunması), ve genel değerlendirilebilirlik kalitesi yönünden ele alınacaktır. Ayrıca grafilerdeki yetişkin parmakları kullanılarak personel maruziyeti hakkında bilgi edinilecektir.
Bulgular: 1438 yenidoğana ait 7333 grafi değerlendirilmiştir. Bir yenidoğana gerçekleştirilen ortalama grafi sayısı 5.1’dir. Grafilerin %83,8’I uygun kolime edilmiştir. Uygun kolimasyon oranı yıllar içerisinde artmıştır. Grafilerin %26,7’si değerlendirme için kötü kalitededir. Grafi kalitesi yıllar içerisinde artmıştır. Tüm grafilerin %87.8’inde erişkin parmağı görülmemiştir.
Sonuç: Radyasyonun efektif kullanılması YDYBU’larda önemli bir meseledir. Yıllar içerisinde grafi kalitesi yükselmiştir, özellikle uygun kolimasyon oranı giderek artmıştır. Personelin radyasyon maruziyeti ise azalmaya başlamıştır.

Kaynakça

  • 1. Wallingford K, Rubarth LB. Development and Evaluation of a Radiation Safety Program in the NICU. Neonatal Netw. 2017;36(5):306-12.
  • 2. Martin JA, Kochanek KD, Strobino DM, Guyer B, MacDorman MF. Annual summary of vital statistics—2003. Pediatrics. 2005;115(3):619-34.
  • 3. Bader D, Datz H, Bartal G, Juster A, Marks K, Smolkin T, et al. Unintentional exposure of neonates to conventional radiography in the neonatal intensive care units. Journal of Perinatology. 2007;27(9):579-85.
  • 4. Yu C-C. Radiation safety in the neonatal intensive care unit: too little or too much concern? Pediatrics & Neonatology. 2010;51(6):311-9.
  • 5. Burrage JW, Rampant PL, Beeson BP. Scatter and transmission doses from several pediatric X-ray examinations in a nursery. Pediatric radiology. 2003;33(10):704-8.
  • 6. Russell J, Burbridge BE, Duncan MD, Tynan J. Adult fingers visualized on neonatal intensive care unit chest radiographs: what you don't see. Canadian Association of Radiologists' Journal. 2013;64(3):236-9.
  • 7. Tynan JR, Duncan MD, Burbridge BE. Reduction of adult fingers visualized on pediatric intensive care unit (PICU) chest radiographs after radiation technologist and PICU staff radiation safety education. Canadian Association of Radiologists' Journal. 2009;60(4):182-4.
  • 8. Dinhofer DS. Reducing radiation exposure in the neonatal intensive care unit: how a process improvement plan can have wide-reaching effects. J Am Coll Radiol. 2014;11(1):88-93.
  • 9. Hellwig BJ, Wilson B. Quality Improvement Related to Radiation Safety of Chest Radiography in the NICU. Radiology management. 2013;35(2).
  • 10. Smans K, Struelens L, Smet M, Bosmans H, Vanhavere F. Patient dose in neonatal units. Radiat Prot Dosimetry. 2008;131(1):143-7.
  • 11. Ono K, Akahane K, Aota T, Hada M, Takano Y, Kai M, et al. Neonatal doses from X ray examinations by birth weight in a neonatal intensive care unit. Radiation protection dosimetry. 2003;103(2):155-62.
  • 12. Sahota N, Burbridge BE, Duncan MD. Radiation safety education reduces the incidence of adult fingers on neonatal chest radiographs. J Radiol Prot. 2014;34(2):333-7.
  • 13. Fatihoglu E, Aydin S, Gokharman FD, Ece B, Kosar PN. X-ray Use in Chest Imaging in Emergency Department on the Basis of Cost and Effectiveness. Acad Radiol. 2016;23(10):1239-45.

X-Ray in Neonatal Intensive Care Units: Does it Go to the right Direction?

Yıl 2021, Cilt: 18 Sayı: 3, 883 - 887, 25.09.2021
https://doi.org/10.38136/jgon.858753

Öz

Introduction: Radiation safety is a current and important problem for both patients and staff in Neonatal Intensive Care Units (NICUs). In this study we mainly intend to evaluate the quality of radiographic examinations performed in a NICU of a children’s hospital, as well as define the amount of staff exposure. By performing this study, we also want to create awareness about the importance of an adequate radiographic examination of a preterm infant and radiation safety in NICUs.
Methods: Direct portable radiographs performed in NICUs between January 2017-January 2020 were retrospectively evaluated. The researchers have evaluated the quality of the radiographs by proper positioning, proper collimation (excluding head and gonadal areas, including only the demanded area), overall quality of the radiograph for adequate interpretation (good, acceptable, bad), evidence of staff exposure (adult fingers in the radiograph).
Results: 7333 radiographs of 1438 newborns were evaluated. Mean number of performed direct radiographs for a newborn was 5.1 times. 83.8% of the radiographs were properly collimated. Amount of properly collimated radiographs increased over the years. 26.7% of the all radiographs were classified as bad for interpretation. Overall quality of the radiographs was also increased over the years. 87.8% of the radiographs did not contain any adult fingers in 2019.
Conclusion: Effective use of ionizing radiation is an important matter for NICUs. The overall quality of the radiographs has become better by time, especially number of properly collimated radiographs was increased. Exposure of the staff to ionizing radiation has begun to decrease.

Kaynakça

  • 1. Wallingford K, Rubarth LB. Development and Evaluation of a Radiation Safety Program in the NICU. Neonatal Netw. 2017;36(5):306-12.
  • 2. Martin JA, Kochanek KD, Strobino DM, Guyer B, MacDorman MF. Annual summary of vital statistics—2003. Pediatrics. 2005;115(3):619-34.
  • 3. Bader D, Datz H, Bartal G, Juster A, Marks K, Smolkin T, et al. Unintentional exposure of neonates to conventional radiography in the neonatal intensive care units. Journal of Perinatology. 2007;27(9):579-85.
  • 4. Yu C-C. Radiation safety in the neonatal intensive care unit: too little or too much concern? Pediatrics & Neonatology. 2010;51(6):311-9.
  • 5. Burrage JW, Rampant PL, Beeson BP. Scatter and transmission doses from several pediatric X-ray examinations in a nursery. Pediatric radiology. 2003;33(10):704-8.
  • 6. Russell J, Burbridge BE, Duncan MD, Tynan J. Adult fingers visualized on neonatal intensive care unit chest radiographs: what you don't see. Canadian Association of Radiologists' Journal. 2013;64(3):236-9.
  • 7. Tynan JR, Duncan MD, Burbridge BE. Reduction of adult fingers visualized on pediatric intensive care unit (PICU) chest radiographs after radiation technologist and PICU staff radiation safety education. Canadian Association of Radiologists' Journal. 2009;60(4):182-4.
  • 8. Dinhofer DS. Reducing radiation exposure in the neonatal intensive care unit: how a process improvement plan can have wide-reaching effects. J Am Coll Radiol. 2014;11(1):88-93.
  • 9. Hellwig BJ, Wilson B. Quality Improvement Related to Radiation Safety of Chest Radiography in the NICU. Radiology management. 2013;35(2).
  • 10. Smans K, Struelens L, Smet M, Bosmans H, Vanhavere F. Patient dose in neonatal units. Radiat Prot Dosimetry. 2008;131(1):143-7.
  • 11. Ono K, Akahane K, Aota T, Hada M, Takano Y, Kai M, et al. Neonatal doses from X ray examinations by birth weight in a neonatal intensive care unit. Radiation protection dosimetry. 2003;103(2):155-62.
  • 12. Sahota N, Burbridge BE, Duncan MD. Radiation safety education reduces the incidence of adult fingers on neonatal chest radiographs. J Radiol Prot. 2014;34(2):333-7.
  • 13. Fatihoglu E, Aydin S, Gokharman FD, Ece B, Kosar PN. X-ray Use in Chest Imaging in Emergency Department on the Basis of Cost and Effectiveness. Acad Radiol. 2016;23(10):1239-45.
Toplam 13 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Çocuk Sağlığı ve Hastalıkları
Bölüm Araştırma Makaleleri
Yazarlar

Berna UCAN 0000-0002-2109-139X

Çiğdem ÜNER 0000-0002-4846-7764

Yayımlanma Tarihi 25 Eylül 2021
Gönderilme Tarihi 12 Ocak 2021
Kabul Tarihi 7 Mayıs 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 18 Sayı: 3

Kaynak Göster

Vancouver UCAN B, ÜNER Ç. X-Ray in Neonatal Intensive Care Units: Does it Go to the right Direction?. JGON. 2021;18(3):883-7.