Fwd: Re: Pregnancy Test Advised for Trauma Victims Prior to Radiation Exposure

[Chris Alston <alstonc@ODRGE.ODR.GEORGETOWN.EDU>]

>From: "North, David" <DNorth@LIFESPAN.ORG>

>

>I have not yet read the article in the J Am Coll Surg, nor do I know where

>all these data originate, from one trauma center or several. However,

>something seems a bit fishy. Because of our location (lack of another nearby

>trauma center) we are the busiest trauma center in New England with well

>over 100,000 patient visits per year, over 300 per day. And those run the

>gamut from sniffles and stubbed toes to multiple-gunshot victims and motor

>vehicle accident de-capitations. Part of my job is to arrive at

>embryonic/fetal dose estimates for the roughly 25 pregnant women who receive

>x-ray, CT, and nuclear medicine exams every month. Very rarely do I ever

>estimate a dose over 3 rad to the unborn. A CT of the abdomen-pelvis

>delivers about 1.2 rad, depending on the technique. An AP plain film of the

>pelvis along with AP and lateral of the L-S spine will add up to something

>like 0.7 rad. So, I don't know where these investigators came up with all

>those patients whose babies received over 5 rads. Once we did have a woman

>(whose pregnancy was unknown at the time) who had four or five separate

>small bowel exams with fluoro and spots over the course of a week and a half

>because she had some kind of obstructive disease. The dose to her embryo I

>figured at about 7 rads, but her case was quite unusual and far off the norm

>for an emergency room. It sounds as if someone is taking skin dose as dose

>at depth, or using an unrealistic (to me, anyway) method of dose estimation

>in this study of trauma patients.

>

>David L. North, Sc.M. DABR

>Associate Physicist

>Department of Medical Physics

>Main Bldg Rm 317

>Rhode Island Hospital

>593 Eddy St.

>Providence, RI 02903

>ph: (401)444-5961

>fax: (401)444-4446

>dnorth@lifespan.org





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