Is A Protocol Change On The Horizon? A Review Of Current Practice
Gracie Gao1, Michael Neep1, Kayla Cronje1 1Logan Hospital, Brisbane, QLD, Australia
Abstract
Background:
General radiography (x-ray) is an important diagnostic tool in patients presenting with acute abdominal pain. Current international protocol consists of an erect chest x-ray and a supine abdomen x-ray. Despite widespread use, there is little evidence that supports the inclusion of the erect chest x-ray. The aim of this study was to challenge current practice and determine whether the erect chest x-ray is necessary when investigating acute abdominal pain.
Methods:
A six-year retrospective study of adult patients who presented to Logan Hospital’s emergency department with acute abdominal pain between January 1st 2016 to January 1st 2022 was conducted. Examinations that also investigated symptoms of chest pathology (such as pneumonia) and foreign bodies were excluded.
Results:
Out of the 193 examinations performed, only 4 (2%) reported positive findings. Two (1%) patients had a bowel perforation, which was also reported on the abdomen x-ray of the study. No abnormality was detected on 191 (98%) chest x-rays, while two (1%) reported findings that were known, with one (0.5%) reporting a progression in known disease.
Conclusion:
Findings from erect chest x-rays did not contribute to patient treatment in 98% of cases in this study. This raises the question as to whether the current protocol for imaging the acute abdomen should be revised to remove the need for an erect chest x-ray. These findings have wide implications including avoiding unnecessary imaging, reducing patient wait times, and a reduction in radiation exposure.
Biography
Gracie Gao is a radiographer in the Medical Imaging Department, Logan Hospital, Queensland, Australia. She is interested in evidence-based practice and has been involved in several quality assurance audit projects as part of her role.