ED providers lack knowledge about patient rad dose

Emergency department (ED) care providers at all levels may lack knowledge about ionizing radiation exposure, according to an Emory University study published in the Journal of the American College of Radiology.

Providers struggled with ionizing versus non-ionizing modalities and discussing dose with patients, signifying an opportunity for radiologists to aid in closing these knowledge gaps. A questionnaire was sent out to a five-hospital system to assess ionizing radiation expertise among ED physicians, residents and mid-level providers such as nurse practitioners and physicians assistants.

The results were discouraging, according to lead author Noah Ditkofsky, MD, of the University of Toronto, and his team: 44 percent of respondents could not correctly identify which six common modalities used ionizing radiation. They were more likely to claim radiography and fluoroscopy as using non-ionizing radiation, when both use ionizing radiation. These factual errors could result in adverse patient outcomes, and additional education is necessary.

Physicians and residents scored even worse when counseling patients on the effects of doses received during imaging. Half of attending physicians and three-quarters of residents were uncomfortable discussing the risks of specific modalities with patients. Interestingly, MLPs were more comfortable discussing radiation with patients but were more likely to make factual errors about radiation exposure.

There is clearly room for improvement and radiologists can lead the way, according to Ditkofsky et al. While increasing radiological education in medical training could help, participation from the radiology department could be more helpful.

“The implementation of credentialing programs and on-the-job training is an option,” the authors wrote. “Residents, interns and faculty members should look to physicians in the field of radiology as a source of radiation safety knowledge."