Vol. 2, No. 6, July 2012 ISSN 2225-7217
ARPN Journal of Science and Technology
©2011-2012. All rights reserved.
http://www.ejournalofscience.org
533
Appraisal of Reporting of Trauma Images: Implications for Evolving
Red-Dot System in Nigeria
1
Mark C. Okeji,
2
Benjamin E. Udoh M.Sc
, 3
Sobechukwu W. Onwuzu
1
Department of Medical Radiography and Radiological Sciences, Faculty of Health Sciences and Technology,
University of Nigeria, Enugu Campus Nigeria.
2
Department of Radiography and Radiological Science, Faculty of Health Sciences and Technology,
Nnamdi Azikiwe University, Nnewi Campus Nigeria.
3
Department of Radiation Medicines, University of Nigeria Teaching Hospital, Ituku / Ozalla, Nigeria.
1
markokeji@yahoo.com
ABSTRACT
An appraisal of reporting of trauma images in secondary and tertiary health care centers in Nigeria was conducted using
structured questionnaires. The study sought to evaluate how timely trauma radiographs were reported by radiologists and
the implication for recommendation of Red-dot system. Our study revealed that in all the hospitals surveyed only
8(22.2%) have permanent radiologists in her employment and 6(33.3%) have visiting radiologists. All the hospitals have
operational emergency departments with a doctor and a nurse designated on duty. The study showed that it takes between
24 to 72 hours to report emergency radiographs in the surveyed hospitals. The absence of prompt reporting of radiographs
increased the morbidity and mortality experienced in the surveyed hospitals. There is therefore need to introduce Red-dot
system to assist emergency physicians to make prompt and more accurate diagnosis in the absence of a radiologist.
Keywords: Radiographers reporting, Red-dot, Nigeria.
1. INTRODUCTION
Radiographer’s identification of abnormality on
a radiograph also known as Red-dot system in Medical
Imaging is a practice widely used in the United
Kingdom. It is a system whereby there is an initial
radiographer’s reporting by the application of red dots
on the radiographs to highlight abnormalities for the
attention of the referring medical practitioners [
1, 2
]. This
method was introduced due to limited number of
radiologists and the need to promptly report trauma
radiographs. Different modifications of the system are
being practiced in various parts of world at present but
its origin has been traced to an earlier work by
Swinburne [
3
]. Several authors have audited the system
as currently being practiced. Sonex et al [
4
] observed that
only 1% of the pathological changes were missed by the
radiographers. Berman et al [
5
] noted that radiographers’
reporting has reduced the possibility of pathologies
likely to be missed by emergency doctors. They
advocated a protocol of image screening by
radiographers as a standard practice. . Vincent et al [
6
] in
their study noted that the casualty officers many a time
are inexperienced and frequent errors are usually made
by their interpretation when compared with that of a
standard radiologist’s report.
In Nigeria, the Red-dot system has not been
officially introduced in the health care system despite the
limited number of radiologists in the country.
This paper therefore was to assess the rate at
which radiographs are reported in emergency department
of some secondary and tertiary health care centers in
Nigeria with a view to advocating alternatives to
enhance better health care delivery.
2. MATERIAL AND METHOD
This study was designed to cover the six geo-
political zones of Nigeria. Two tertiary and two
secondary health care centres in each of the geo-political
zones were selected for the study giving a total of
twenty-four hospitals. Authorization for the study was
obtained from the hospitals concerned and the aim of the
study was explained to the respondents.
Two sets of structured questionnaires were
designed for the study. The first set of questionnaires
was for the radiographers while the second set was for
the nurses working in the emergency departments of the
same hospitals. The questionnaires were validated by a
Chief radiographer and a Chief Nursing Officer who
were asked to assess the appropriateness and relevance
of the questions. The questions were reviewed after the
pilot study.
A total of 96 questionnaires were sent out to the
radiographers and 81 were received giving a return rate
of 84.4%. For the emergency nurses, 83 questionnaires
were sent out and 71 were received giving a return rate
of 85.5%.The questionnaires to the radiographers sought
to find out; whether emergency radiography services
were provided, the knowledge of the radiographers
towards identification of pathologies, whether
radiographers run on-call-duty services, whether
radiologists are in their employment and hours of
availability. The questionnaires for the emergency nurses
sought to find out; whether the emergency radiographs
of patients were reported and by whom, how long it
takes to be reported, whether the radiographers were
always available to attend to emergency cases and the
implication for morbidity and mortality. This method