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- PublicationInvestigating the ability of radiographers to recognise typical non accidental injury fractures in childrenIntroduction: Child abuse is often underreported by the general population and healthcare professionals for a variety of reasons and, therefore, all avenues to improve the discovery and prevention of child abuse should be explored. Radiographers are well positioned to identify child abuse and in particular Non Accidental Injuries (N.A.I.); having a wealth of experience in image acquisition and visualisation. In the Republic of Ireland Health Care professionals are legally required to report suspicious cases as Designated Officers. Aim: Our aim was to measure radiographers' ability to recognise non-accidental injury fractures in children comparing radiographers from two different European Countries. Method: 22 radiographers working in hospitals in the Republic of Ireland and Slovenia viewed 26 plain radiographic images (13 NAI fractures/13 accidental fractures) and rated their confidence on a scale from 1 to 6 that a fracture was either accidental (1-3) or non-accidental (4-6). The images were viewed using ViewDex software on a laptop calibrated to DICOM greyscale standard display function. Viewing conditions were standardised and optimised. An ROC curve was plotted and sensitivity, specificity and area under the curve (AUC) were calculated for each radiographer. Results: The results demonstrated a difference in values which AUC was statistically significant (P=0.0111)Conclusion: Further research would be beneficial with more images, full skeletal surveys, and paediatric radiologist(s) as a gold standard for comparison.
- PublicationOne and done? Outcomes from 3961 patients managed via a virtual fracture clinic pathway for paediatric fracturesPurpose The aim of this paper is to describe our experience with a virtual fracture management pathway in the setting of a paediatric trauma service.Methods All patients referred to the virtual fracture clinic service from the Paediatric Emergency Department (PED) were prospectively collected. Outcome data of interest (patients discharged, referred for urgent operative treatment, referred back to emergency department for further evaluation, referred for face-to-face clinical assessment and all patients who re-presented on an unplanned basis for further management of the index injury) were compiled and collated. Cost analysis was performed using established costing for a virtual fracture clinic within the Irish Healthcare System.Results There were a total of 3961 patients referred to the virtual fracture clinic from the PED. Of these, 70% (n = 2776) were discharged. In all, 26% (n = 1033) were referred to a face-to-face appointment. Of discharged patients, 7.5% (n = 207) required an unplanned face-to-face evaluation. A total of 0.1% (n = 3) subsequently required operative treatment relating to their index injury. Implementation of the virtual fracture clinic model generated calculated savings of €254 120.Conclusion This prospective evaluation has demonstrated that a virtual fracture clinic pathway for minor paediatric trauma is safe, effective and brings significant cost savings.