The Critical Decision: Comparing Chest Radiographs at the Bedside and in the Examination Room

Abstract

The transportation of critically ill patients for diagnostic exams requires extreme caution, as it may compromise their clinical stability. To minimize these risks, strict protocols must be followed to ensure patient safety. This study evaluated image quality (IQ) in bedside chest radiographs compared to those performed in the examination room. Ten semi-anatomical phantom images were analyzed while maintaining a constant exposure index. The results indicated that the examinations performed in the examination room increased the contrast (27.19%) (p = 0.003), but also increased the dose at the entrance surface (371.70%) (p < 0.001) due to the use of an anti-scatter grid inherent to the examination room, however, there was a degradation in the average value of the signal-to-noise ratio (SNR) (42%) (p = 0.02). Conversely, bedside images had lower radiation dose and higher SNR but lower contrast. The decision to transport the patient should balance diagnostic accuracy and radiation safety, guided by clinical judgment. Future studies may optimize protocols to enhance IQ while minimizing radiation exposure.