WP3.17 - Rationalising the use of Abdominal X Ray to ensure the best utilisation of clinical radiology services

Abstract Aim To rationalise indications for Abdominal Xray (ABXR). Method All patients undergoing ABXR from 1st September 2022 to 31st December 2022 were included timing the Xray, requesting department and grade of doctor noted We compared the indications of the request and whether patients proceeded to CT scan. Based on the iRefer recommendations Grade C as well as need of CT, inappropriate requests were identified and ones that could be avoided. Results 279 patients underwent ABXR 184 Xrays were done during in hours(IH) (0800-2000hrs) 175 requests originated from A&E, 103 from Wards and 1 from GP. 137/279 ABXR were requested for obstruction. 37/279 for Foreign Body. Other common IH requests included identifying retained capsule, post enteral tube placements as well as diagnostic/therapeutic gastrograffin result. IH request also included identification of renal stones following CT KUB. 134/279 concurred with Recommendation A/B and 145/279 Recommendation C of iRefer guidelines. 62/279 patients underwent post ABXR CT scan. 70% (43/62) were to rule out obstruction for which in the majority ABXR would not be indicated. Of these 49% (21/43) were normal and 51% (22/43) showed obstruction. 45/62 of the patients who underwent CT had an avoidable ABXR. In total 144 ABXRs could have been avoided. 1 request was from GP and hence could not be commented on. Conclusions Avoiding abdominal Xray will improve patient care, bypassing inadequate tests and moving straight to CT where clinically appropriate. Rationalising the use of ABXR will minimise overburdening clinical radiology services and decrease unnecessary exposure of radiation to patients.