Atci Ibrahim B, Yilmaz Hakan, Antar Veysel, Ozdemir Nuriye G, Baran Oguz, Sadillioglu Sila, Ozel Mehmet, Turk Okan, Yaman Mehmet, Topacoglu Hakan
Department of Neurosurgery, Istanbul Education and Research Hospital, Istanbul, Turkey.
Department of Neurosurgery, Duzce State Hospital, Duzce, Turkey -
J Neurosurg Sci. 2017 Dec;61(6):597-602. doi: 10.23736/S0390-5616.16.03418-4.
The aim of this study was to determine the knowledge of neurosurgeons and emergency physicians about ALARA (as low as reasonably achievable) and to gain awareness to them about this topic.
A multiple-choice survey comprising 17 questions was performed to 30 neurosurgeons and 70 emergency room doctors.
Emergency medicine doctors, neurosurgeons, emergency medicine residents, neurosurgery residents and general practitioners participated in the survey. Sixty-six percent of participants stated that they examined more than 50 patient with headache, dizziness and head trauma in emergency service per diem and more than half of the participants stated that brain CT was performed in the event of patient's request, even if there was not an indication. 75% of the participants stated that they requested CT scan without neurological examination when the number of patients increased in the emergency room. Eighty-three percent of the participants did not think there was a safe dose limit in CT, 92% did not know the radiation dose received during brain CT, 96% did not know the meaning of the ALARA. Fifty-seven percent of the participants stated that if they informed about the criteria of ALARA, they will take into acount these criteria while requesting CT scan.
In our country, doctors working in emergency services request brain CT needlessly because of taking into account the patient's wish and fear of malpractice. The knowledge of the neurosurgeons and emergency service doctors about ALARA is insufficient. It is necessary to educate our physicians about ALARA protocol, for taking these criteria into their consideration when requesting CT examination. For protecting the patients from the effects of ionizing radiation and reducing the economic loss of hospitals, it is necessary to increase awareness of the ALARA protocol and to increase the number of hospitals which protocol is applied.
本研究的目的是确定神经外科医生和急诊科医生对“合理尽可能低（ALARA）”原则的了解情况，并提高他们对该主题的认识。
对30名神经外科医生和70名急诊科医生进行了一项包含17个问题的多项选择题调查。
急诊科医生、神经外科医生、急诊科住院医师、神经外科住院医师和全科医生参与了调查。66%的参与者表示他们每天在急诊服务中检查超过50例头痛、头晕和头部外伤患者，超过一半的参与者表示即使没有指征，在患者要求时也会进行脑部CT检查。75%的参与者表示当急诊室患者数量增加时，他们在没有进行神经学检查的情况下就要求进行CT扫描。83%的参与者认为CT检查不存在安全剂量限制，92%的人不知道脑部CT检查时所接受的辐射剂量，96%的人不知道ALARA的含义。57%的参与者表示，如果他们了解了ALARA的标准，在要求进行CT扫描时会考虑这些标准。
在我国，急诊服务部门的医生由于考虑患者的意愿和对医疗事故的恐惧，不必要地要求进行脑部CT检查。神经外科医生和急诊服务医生对ALARA的了解不足。有必要对我们的医生进行关于ALARA协议的教育，以便他们在要求进行CT检查时考虑这些标准。为了保护患者免受电离辐射的影响并减少医院的经济损失，有必要提高对ALARA协议的认识，并增加应用该协议的医院数量。
