Corrigendum: Evaluation of self-reported confidence amongst radiology staff in initiating basic life support across hospitals in the Cape Town Metropole West region

No abstract available.

Use of High-fidelity simulation training for radiology healthcare professionals in the management of acute medical emergencies

Objectives: Life-threatening emergencies are relatively uncommon in the radiology department, but when encountered, require timely intervention. With an increasing number of critically unwell patients visiting the radiology department each year for both diagnostic and interventional procedures, it is vital that radiology staff are trained to provide basic resuscitation before further assistance arrives. Simulation training is a well-validated, effective method for rehearsing low-frequency, high-acuity events in a supportive and safe environment. The aim of our study was to investigate whether the introduction of a focussed, multidisciplinary simulation course would improve healthcare professional’s knowledge and confidence when managing common medical emergencies; including cardiac arrest, anaphylaxis and airway obstruction. Methods: A multidisciplinary group of radiology staff attended a dedicated simulation teaching course. Participants completed a pre- and post-test questionnaire which assessed a range of knowledge domains and their perceived confidence with dealing with the clinical scenarios. The delegates were then asked to repeat this questionnaire 6 months after taking part in the course to assess their retention of skills and knowledge. Results: Knowledge scores increased by a mean difference of 4 points (p < 0.001). The mean pre- and post-course perceived confidence scores were 4.4/10 and 8/10, respectively. Advances in knowledge: This study suggests that embedding simulation training into the radiology curriculum improves healthcare professional’s knowledge and perceived confidence when dealing with common medical emergencies. Although previous studies have looked at the use of simulation training for radiology trainees in the management of selected medical emergencies, to the authors’ knowledge, this is the first study to demonstrate these benefits across a range of clinical scenarios, within an interprofessional environment.

Impact factors for safety, success, duration and radiation exposure in CT-guided interventions

Objective: We aim to compare factors influencing safety, success rate and radiation dose of CT-guided biopsies and drainages in a non-teaching setting with experienced operators vs a teaching setting with residents. Methods: A total of 1021 cases were retrospectively analyzed regarding lesion size, distance from skin, procedure duration, radiation dose, complications and clinical success. Procedures were grouped into biopsies of lung, liver, (remaining) abdomen, musculoskeletal system (MSK) and drainages of any region. Procedures in non-teaching setting were performed by experienced operators (full time interventional radiology staff), teaching setting consisted of residents under supervision of interventional radiology staff. Results: Overall clinical success rate was 93.6 % [experienced (exp.) vs teaching setting: 93.5 and 93.6 %, p = 0.97]. Overall complication rate was 7.2% (5.7% minor, 1.6% major; exp. vs teaching: 8.0 and 6.5 %, p = 0.67]. Experienced operators performed chest and liver biopsies faster even though they were facing smaller lesions. Multiple regression analysis revealed that depth from skin significantly increased procedure duration by 36.8 s per cm (p < 0.001) and also radiation dose by 5.4 mGy per cm (p < 0.001) in all interventions. On average, teaching setting increased the duration of an intervention by 209.8 s and total radiation dose by 10.6 mGy (p < 0.001, p < 0.001 respectively). Conclusion: CT guided interventions can be performed safe und successful disregarding anatomical parameters or teaching setting. Depth from skin and teaching setting should be taken into account both from a clinical and a time-conscious point of view since they increase radiation dose and prolong operations. Advances in knowledge: This is the first study with >1000 interventions which shows and quantifies the impact of lesion depth and teaching setting in CT-guided interventions.

ASSESSMENT ON THE INTERCHANGEABILITY OF PERSONAL EFFECTIVE DOSE ALGORITHMS IN FLUOROSCOPY-GUIDED INTERVENTIONS USING BLAND-ALTMAN ANALYSIS

Long exposure to radiation from fluoroscopy-guided interventions (FGIs) can be detrimental to both patients and radiologists. The effective doses received by the interventional radiology staff after performing 230 FGIs in a year were assessed by using double dosimetry and five various algorithms. The Shapiro–Wilk test revealed normally-distributed data (p &lt; 0.01), while the significant correlation coefficients between the effective doses ranged between 0.88 and 1.00. As for the Bland–Altman analysis, both Niklason and Boetticher algorithms strongly supported the absence of statistical significance between the estimated effective doses. This portrays that the occupational doses received by the interventional radiology staff during FGIs fall within the acceptable limit regardless of the varied algorithms applied. In short, the Niklason and Boetticher algorithms appeared to be the more interchangeable ones for effective evaluation of doses. This is in view of their strong mutual correlations and excellent agreement.