The use of bedside chest radiography at a university hospital. Data on a two-week period.

OBJECTIVE

To evaluate the requests for bedside chest radiography (BCR) by clinicians.

MATERIALS AND METHODS

After IRB approval, we retrieved the patients' clinical records for demographics, unit, and duration for recovery in a two weeks period. For each BCR, exposure data and the reason for BCR were registered. The BCR results were categorized as one or more of the followings: negative, regular/irregular device position, known finding(s) unmodified/modified in respect with the previous BCR, new expected finding(s) (pleural effusion, low ventilation), or new unexpected findings (pulmonary edema, pneumothorax). As a utility indicator of BCR, we considered the rate of chest CT performed in these patients during the study period and the following week. We have estimated the effective radiation dose.

RESULTS

A total of 337 BCRs (126 patients) entered the analysis, 74% of them being performed in post-surgery intensive care unit. Seventy-3 patients (58%) performed 1 or 2 BCRs, 53 (42%) 3 or more BCRs with a maximum of 13 BCRs performed on a newborn. The mean total effective dose was 0.2 mSv/patient (maximum 1 mSv). In post-surgery intensive care unit the mean daily BCR rate was 0.8/day (maximum 2/day). On 337 BCR requests, 49% showed no motivations at all, 42% reported the word "check" and in 9% a well-defined clinical query was specified. The rate of incorrect catheter position and new unexpected findings was 4%. One chest CT have been requested.

CONCLUSION

BCR is often requested as a routine examination with a little rate of unexpected findings.