key: cord-0692746-qtcsqicm
authors: Davies, Gareth; Paterson, Anne; Fitzsimons, Andrew
title: Radiology referrals from the emergency department during the United Kingdom lockdown of 2020
date: 2022-03-15
journal: Pediatr Radiol
DOI: 10.1007/s00247-022-05342-6
sha: bb35235da30e91c48bd1ac682d38908390d6899b
doc_id: 692746
cord_uid: qtcsqicm

nan

In the 2019 month, 596 children had trauma radiographs, with this number falling to 246 in the same month in 2020, a reduction of 58.7%. In the 2021 study period, numbers exceeded pre-COVID figures, with 604 children requiring imaging for extremity injury. Conversely, the number of children with fractures on their radiographs increased from 37.3% in 2019 to 53.4% in 2020, falling back to 34.9% in 2021. All fractures diagnosed in 2019 were acute, but three children presented with healing injuries in 2020 and one in 2021; all four were older children and there was no suspicion of inflicted injury in any of the groups studied. We further looked at "re-attenders" to the Emergency Departmentthose returning with the same complaint. In 2020, only a single child returned to the department. Pre-pandemic there were 15 children across the month, and in 2021, this figure increased to 27.

In 2019, 172/582 (30%) children were injured in ways that would become inaccessible to children during lockdown: at schools or in public play areas, at the homes of friends or relatives and whilst participating in team sports. All children in the 2020 group had "COVID-compliant" injury mechanisms. With some easing of restrictions during the 2021 month, 177/605 (29%) injuries would not have been possible during the 2020 lockdown based on mechanism.

In summary, our data imply that during the first lockdown, children with more minor injuries were being cared for at home rather than attending the Emergency Department, but also that attendance numbers fell because of the reduction in available play and sports activities. As time has progressed, attendances involving peripheral trauma imaging have rebounded, exceeding pre-COVID-19 levels, with the percentage of abnormal radiographs (positive for fracture) decreasing to those seen pre-pandemic. Reasons for these trends are likely varied and might be related to increased freedoms following relaxation of restrictions, e.g., attending school and team sports activities, fatigue (and reduced fear) surrounding remaining COVID-19 restrictions, or a perceived reduction in access to local primary care.

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