I'd agree with you. Here we remove the board and clothing prior to clearing
the spine. Furthermore, I go by the EAST guidelines on clearing spines
clinically (no tenderness, no pain on movement, no distracting injury, no
obtundation of conscious level). Still means you x-ray a lot, but a study to
reduce x-rays further would have to be huge. Clearly this was a technically
difficult case. You've mentioned the use of 5 radiographers, but what grade
of radiologist was involved? Surely if your SHO was not confident about
interpretation of trauma obliques they could have called their consultant.
Matt Dunn
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