IntroductionRadiation dose to patients undergoing invasive coronary angiography (ICA) is relatively high. Guidelines suggest that a local benchmark or diagnostic reference level (DRL) be established for these procedures. This study sought to create a DRL for ICA procedures in Queensland public hospitals.MethodsData were collected for all Cardiac Catheter Laboratories in Queensland public hospitals. Data were collected for diagnostic coronary angiography (CA) and single-vessel percutaneous intervention (PCI) procedures. Dose area product (PKA), skin surface entrance dose (KAR), fluoroscopy time (FT), and patient height and weight were collected for 3 months. The DRL was set from the 75th percentile of the PKA.Results2590 patients were included in the CA group where the median FT was 3.5 min (inter-quartile range = 2.3–6.1). Median KAR = 581 mGy (374–876). Median PKA = 3908 uGym2 (2489–5865) DRL = 5865 uGym2. 947 patients were included in the PCI group where median FT was 11.2 min (7.7–17.4). Median KAR = 1501 mGy (928–2224). Median PKA = 8736 uGym2 (5449–12,900) DRL = 12,900 uGym2.ConclusionThis study established a benchmark for radiation dose for diagnostic and interventional coronary angiography in Queensland public facilities.

Background Professional competencies are important for enhancing alignment between the needs of education, industry, and health consumers, whilst describing public expectations around health professionals. The development of competency standards for the sonography profession defines the behaviours, skills and knowledge sonographers should demonstrate for each learning and experience level. Methods Representatives of three Australian ultrasound professional associations and seven tertiary institutions involved in entry-level sonographer education in Australia formed a research team. The research team recruited an expert panel that responded to six survey rounds. Using a Delphi methodology, the results and free-text comments from each previous round were fed back to participants in the subsequent survey rounds to achieve consensus. Results The project developed a professional competency framework for sonographers which included four major domains: Detailed competency standards, sonographer knowledge, sonographer attitudes and a holistic competency matrix [https://doi.org/10.6084/m9.figshare.17148035.v2.] Conclusion The Delphi methodology is an effective way to develop professional competency standards. This paper describes the methods and challenges in developing such standards for sonographers which could be translated to other health professionals.

Introduction: Ultrasound is a common first-line examination in acute abdominal pain in children. In rural and regional areas, ultrasound is an important factor in decisions to transfer paediatric patients for tertiary care. Transfers can be over a considerable distance, by road and air, and at great cost. This audit reviewed ultrasound findings in children transferred to an Australian paediatric hospital for acute abdominal pain.Methods: Children transferred for acute abdominal pain between July 2018 and June 2019 was identified. Imaging findings at the transferring and receiving facility were reviewed, along with the patient's electronic medical record. Suspected and final diagnoses were recorded, and the accuracy of imaging evaluated.Results: There were 172 transfers identified, mean age was 6 years 1 month, 66.3% were boys. Mean transfer distance was 55.4 km. The majority were suspected acute appendicitis (63.9%), followed by intussusception (20.3%), and hypertrophic pyloric stenosis (14.5%). The majority of suspected diagnoses were ultimately false positives including pyloric stenosis, 52.0%; appendicitis, 50.9% and ileo-colic intussusception, 74.3% of cases negative. Conclusion:Improved diagnostic accuracy in evaluating causes of acute paediatric abdominal pain with ultrasound, particularly appendicitis, pyloric stenosis, and intussusception is required. Targeted education and clinical support mechanisms may reduce potentially unnecessary inter-hospital transfers and their considerable associated costs.