Shrikant, Ketaki NawlakhePournami, FemithaPanackal, Anila VPrithvi, Ajai KumarPrabhakar, JyothiJain, Naveen2023-08-252023-08-252023-07Shrikant Ketaki Nawlakhe, Pournami Femitha, Panackal Anila V, Prithvi Ajai Kumar, Prabhakar Jyothi, Jain Naveen. Effect of Clinician-directed Technical Specifications on Entrance Skin Doses in Neonates. Indian Pediatrics. 2023 Jul; 60(7): 537-5400079-60610974-7559http://imsear.searo.who.int/handle/123456789/225435Objectives: To compare the entrance skin doses (ESD) before and after implementation of a radiation safety policy in neonates (RSN), which focused on clinician-directed technical specifications on the digital X-ray machine. Methods: Prospective observations included two sets of X-rays: Before (BRSN) and after (ARSN) implementation of RSN (documented indication for Xray/expected posttest findings, settings of 40 kVp, 0.5 mAs, film-focus distance 100 cm, gonadal-shield, optimal collimation, and post-shoot image-enhancement). Results: 33 and 32 X-rays were analyzed in respective groups. Mean (SD) of calculated and machine-quantified ESD (µGy/m2) was higher in BRSN group as compared to ARSN group (P <0.001). All ARSN X-rays were interpretable for expected post-test findings. Conclusion: Clinicians’ cognizance of ability to make consequential bedside technical specifications, can reduce ESD without affecting interpretability. These single observations could have a larger impact in sick neonates, where multiple X-rays are done.ALARAFilm-focus distanceKilovoltage-peakRadiation safetyJournal ArticleIndiaDepartment of Neonatology, Kerala Institute of Medical Sciences (KIMS) Health, Trivandrum, Kerala