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外科住院医师、急诊医学医师和护士在创伤患者复苏过程中会受到大量辐射照射吗?

Do surgical residents, emergency medicine physicians, and nurses experience significant radiation exposure during the resuscitation of trauma patients?

作者信息

Ciraulo D L, Marini C P, Lloyd G T, Fisher J

机构信息

Department of Surgery, Polyclinic Medical Center, Harrisburg, Pennsylvania.

出版信息

J Trauma. 1994 May;36(5):703-5. doi: 10.1097/00005373-199405000-00018.

DOI:10.1097/00005373-199405000-00018
PMID:8189474
Abstract

During this study we investigated the yearly risk of radiation exposure for surgical residents (group 1, n = 8), emergency department (ED) physicians (group 2, n = 6) and nurses (group 3, n = 97) participating in the resuscitation of trauma victims in the emergency department of a 500-bed teaching hospital. Dosimeter readings of the three study groups were recorded monthly over the 1-year study period. During the study interval, 758 patients underwent resuscitation following trauma; 2098 portable radiographs (758 chest films, 758 lateral cervical spine films, and 582 radiographs of the pelvis) were obtained during the resuscitation phase of these patients. The total radiation exposure for group 3 was significantly greater than that for groups 1 and 2 (340 +/- 50 vs. 160 +/- 112 and 20 +/- 14 mrem, respectively, p < 0.01). Individual residents received a significantly greater amount of radiation than ED physicians and nurses (20 +/- 28 vs. 3.3 +/- 2.0 and 3.5 +/- 2.0 mrem, respectively, p < 0.05). However, despite repeated exposure to radiation, individuals in the three groups did not exceed the safety limits of 0.05 Gy/year set by the National Council on Radiation Protection and Measurements. Based on the results of this study, we conclude that trauma resuscitation teams can provide quality care to their patients without concern over the detrimental effects of radiation exposure, provided that the basic principles of radiation protection are followed.

摘要

在本研究中,我们调查了一家拥有500张床位的教学医院急诊科参与创伤患者复苏的外科住院医师(第1组,n = 8)、急诊科医生(第2组,n = 6)和护士(第3组,n = 97)的年度辐射暴露风险。在为期1年的研究期间,每月记录三个研究组的剂量计读数。在研究期间,758例患者接受了创伤复苏;在这些患者的复苏阶段共获取了2098张便携式X光片(758张胸部X光片、758张颈椎侧位X光片和582张骨盆X光片)。第3组的总辐射暴露量显著高于第1组和第2组(分别为340±50与160±112和20±14毫雷姆,p < 0.01)。个体住院医师接受的辐射量显著高于急诊科医生和护士(分别为20±28与3.3±2.0和3.5±2.0毫雷姆,p < 0.05)。然而,尽管反复暴露于辐射,但三组人员均未超过美国国家辐射防护与测量委员会设定的每年0.05 Gy的安全限值。基于本研究结果,我们得出结论,只要遵循辐射防护的基本原则,创伤复苏团队就可以为患者提供优质护理,而无需担心辐射暴露的有害影响。

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Emerg Radiol. 2014 Feb;21(1):11-5. doi: 10.1007/s10140-013-1160-6. Epub 2013 Sep 19.
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Radiation dose from initial trauma assessment and resuscitation: review of the literature.初始创伤评估与复苏的辐射剂量:文献综述
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