(Risks described are approximations for a 45-year-old person; risks are halved for 70- year-olds, doubled for 20-year-olds, and quadrupled for young children) “Mr. Smith. The best way I can diagnose your pain is a CT scan. This means having radiation exposure. I will explain how much radiation. You are always exposed to ‘background’ radiation from the ground, stars, air, and food. To use money as an example, it is 2 cents per hour. For comparison, a chest x-ray is $2 and the abdominal CT scan is $1,000 of radiation. Risk of cancer during your lifetime increases by about 1 in 1,000 for every $1,000 of radiation exposure. Of 1,000 people, about 420 will have cancer in their lifetimes. Therefore, every $1,000 of radiation increases the cancer risk from 420 to 421 of 1,000. About half the cancers are fatal. You can see that the risk of cancer from the CT scan is low. For every 1,000 patients getting your scan, only 1 will probably get cancer because of it. I recommend the scan for you because I believe the benefit of diagnosis outweighs the risk. If you disagree, we can discuss other options that avoid radiation exposure, but these may be less helpful in diagnosing your pain. A delay in diagnosis also carries a risk of complications or death.” Veysman, Acad Emerg Med 2009 16:1 p95 also SmartEM.org CT Consent 2011 also, from Michelle Lin: also, from Safety of Radiographic Imaging During Pregnancy: Am Fam Physician. 1999 Apr 1;59(7):1820.
Money scale for use in explaining radiation exposure, and other exposure tables from common radiology testsNovember 25th, 2009
by reuben in health maintenance, radiology
by reuben in health maintenance
Andrus summary, based on the CDC recommendations age <7 years: DTaP age <7 years with pertussis contraindicated DT 7-18: Tdap 7-18: with pertussis contraindicated: DT age > 18 if > 10 years give Tdap CDC Recommendations for Tetanus in pregnancy Commercial Names DTap (lower concentrations of antigens, acellular pertussis): daptacel Tdap (higher concentrations of antigens, acellular pertussis): adacel DTP (lower concentrations of antigens, killed whole cell pertussis – for age <6): trivax Td (higher concentrations of antigens, no pertussis): no commercial name Tetanus toxoid (higher concentration, only tetanus): no commercial name
CDC Recommendations per guidelines.gov
144. % pneumococcal pneumonia with pneumococcemia / Indications for 23 valent vaccine / Indications for 7 valent vaccineDecember 23rd, 2007
by reuben in health maintenance, pneumonia