Audit on Standard of Radiographs Done in NICU

Background: In neonatal age, smaller body size, high heart rate and respiratory rate are some causes which makes radiographs difficult to obtain. Some neonates cannot be repositioned due to illness. Neonates in NICU require repeated radiographic evaluation that increases exposure. As new-borns are more radiosensitive and risk of radiation induced malignancy is high, so it is necessary to get the best x-ray the first time.

Objective: To assess whether the quality of radiographs done in NICU meets international and national guidelines.

Methods: We assessed 19 parameters in 207 sequential plain radiographs of babies in NICU, Royal Stoke Hospital. Results: Out of 207 radiographs, more than 90% of X-rays were done within one hour of request. Clinical history was available in more than 90% of requests. In 75% correct radiographs, X-rays were repeated in less than 4% of cases. ID check was 100%. On the other hand, Pre-exposure side marker was used in only 12% of X-Rays.

Recommendations: It is recommended to draw up local imaging guideline for neonates, to adhere to the local Diagnostic Reference Levels (DRLs) for doses and recruit paediatric radiographers who can provide training to other colleagues. There is need to use smaller anatomical markers before exposure.