AB167. The appropriate use of plain film abdomen in the acute surgical assessment unit: the experience of a model three Irish hospital

Background: A plain film abdomen (PFA) can be a useful modality of imaging if used in the correct circumstances. However, when used inappropriately, it leads to unnecessary cost (€85 per scan), waste of resources and increases patients’ exposure to radiation.

Methods: A single centre retrospective study was conducted in the Acute Surgical Assessment Unit of a Model 3 Irish Hospital over a 12-day period in October 2019. Data was obtained using a Patient Census Book and the National Integrated Medical Imaging System. Recorded indications for the PFAs were compared against the Royal College of Radiologists (RCR) guidelines.

Results: A total of 207 patients were reviewed, 113 males and 94 females, with a median age of 45. In 67 out of 207 patients (31.4%) a PFA was performed. A total of 31 (46.3%) were valid indications. A significant finding was present in 6 of the PFAs none related to the presenting complaint.

Conclusions: Based on RCR guidelines regarding the indications for PFA, >50% of the patients that had a PFA for reasons not indicated by their presenting complaint. The cost saving initiative is important—however, patient safety is a major issue, and unwarranted exposure to radiation for patients is an unnecessary hazard which could easily be avoided. We hope with these results to increase awareness amongst doctors and radiographers to help reduce both cost to patient and hospital.

Keywords: Appropriate indications; finances; patient safety