Floriani Isabela Dombeck, Borgmann Ariela Victoria, Barreto Marina Rachid, Ribeiro Elaine Rossi
Faculdades Pequeno Príncipe, Curitiba, PR, Brazil.
Rev Paul Pediatr. 2020 Dec 18;40:e2020302. doi: 10.1590/1984-0462/2022/40/2020302. eCollection 2020.
To analyze literature data about unnecessary exposure of pediatric emergency patients to ionizing agents from imaging examinations, nowadays and during times of COVID-19.
Between April and July 2020, articles were selected using the databases: Virtual Health Library, PubMed and Scientific Electronic Library Online. The following descriptors were used: [(pediatrics) AND (emergencies) AND (diagnostic imaging) AND (medical overuse)] and [(Coronavirus infections) OR (COVID-19) AND (pediatrics) AND (emergencies) AND (diagnostic imaging)]. Inclusion criteria were articles available in full, in Portuguese or English, published from 2016 to 2020 or from 2019 to 2020, and articles that covered the theme. Articles without adherence to the theme and duplicate texts in the databases were excluded.
61 publications were identified, of which 17 were comprised in this review. Some imaging tests used in pediatric emergency departments increase the possibility of developing future malignancies in patients, since they emit ionizing radiation. There are clinical decision instruments that allow reducing unnecessary exam requests, avoiding over-medicalization, and hospital expenses. Moreover, with the COVID-19 pandemic, there was a growing concern about the overuse of imaging exams in the pediatric population, which highlights the problems pointed out by this review.
It is necessary to improve hospital staff training, use clinical decision instruments and develop guidelines to reduce the number of exams required, allowing hospital cost savings; and reducing children's exposure to ionizing agents.
分析有关儿科急诊患者在当前以及新冠疫情期间因影像学检查而遭受不必要的电离辐射暴露的文献数据。
2020年4月至7月期间，使用虚拟健康图书馆、PubMed和科学电子图书馆在线数据库筛选文章。使用了以下描述词：[(儿科) AND (急诊) AND (诊断成像) AND (医疗过度使用)]以及[(冠状病毒感染) OR (新冠病毒病) AND (儿科) AND (急诊) AND (诊断成像)]。纳入标准为2016年至2020年或2019年至2020年以葡萄牙语或英语全文发表且涵盖该主题的文章。排除未紧扣主题以及数据库中重复的文本。
共识别出61篇出版物，本综述纳入了其中17篇。儿科急诊科使用的一些影像学检查会增加患者未来发生恶性肿瘤的可能性，因为它们会发出电离辐射。有临床决策工具可减少不必要的检查申请，避免过度医疗化以及节省医院开支。此外，随着新冠疫情的爆发，人们越来越担心儿科人群中影像学检查的过度使用，这凸显了本综述所指出的问题。
有必要加强医院工作人员培训，使用临床决策工具并制定指南以减少所需检查的数量，从而节省医院成本；并减少儿童对电离辐射的暴露。
