Managing radiation risk in the evaluation of the pediatric trauma patient

Pediatric trauma is usually a nonoperative experience for the pediatric general surgeon. The pediatric trauma surgeon resuscitates the child and then evaluates and triages the identified injuries. A common diagnostic tool is the computed tomography (CT) scan. Most children who require evaluation for significant trauma will get a CT scan, but there are no national guidelines directing the assessment. Injuries to the head, cervical spine, chest, and abdomen can all be imaged with a CT scan; the question is whether the liberal approach to imaging children is appropriate. Over the past decade, concern has arisen about the radiation dose delivered by CT. This concern has generated a national campaign to "image gently." This article reviews the data involving the risk of medical radiation exposure and discusses strategies for managing the risk. (C) 2010 Elsevier Inc. All rights reserved.