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Home Suspected Physical Abuse-Child
Variants
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Physical abuse suspected, concern for skull injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199722
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for cervical spine injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199723
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for thoracic spine injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199724
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography thoracic spine
1-10 mSv
☢☢☢
May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for lumbar spine injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199725
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography lumbar spine
1-10 mSv
☢☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for chest injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199726
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for wrist injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199727
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography wrist
<0.1 mSv
☢
May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for elbow injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199728
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography elbow
<0.1 mSv
☢
May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for femur injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199729
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography femur
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for foot injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199730
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography foot
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for hand injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199731
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography hand
<0.1 mSv
☢
May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for hip injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199732
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography hip
1-10 mSv
☢☢☢
May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for knee injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199733
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography knee
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for humerus injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199734
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography humerus
<0.1 mSv
☢
May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for lumbosacral spine injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199735
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography lumbosacral spine
1-10 mSv
☢☢☢
May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for radius and ulna injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199736
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography radius and ulna
<0.1 mSv
☢
May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for ribs injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199737
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography ribs


May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for shoulder injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199738
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography shoulder
<0.1 mSv
☢
May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for thoracic and lumbar spine injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199739
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography thoracic and lumbar spine
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for tibia and fibula injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199740
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography tibia and fibula
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for abdominal injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199741
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography abdomen
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for pelvic injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199742
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography pelvis
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for ankle injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199743
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography ankle
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for cervical and thoracic spine injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199744
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography cervical and thoracic spine
1-10 mSv
☢☢☢
May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for cervical and lumbar spine injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199745
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography cervical and lumbar spine
1-10 mSv
☢☢☢
May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for complete spine injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199746
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography complete spine

0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Physical abuse suspected, concern for abdominal injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199748
Radiography abdomen
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for chest injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199749
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for pelvic injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199750
Radiography pelvis
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for ankle injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199751
Radiography ankle
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for cervical spine injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199752
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for cervical and lumbar spine injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199753
Radiography cervical and lumbar spine
1-10 mSv
☢☢☢
Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for cervical and thoracic spine injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199754
Radiography cervical and thoracic spine
1-10 mSv
☢☢☢
Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for complete spine injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199755
Radiography complete spine

0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for elbow injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199756
Radiography elbow
<0.1 mSv
☢
Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for femur injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199757
Radiography femur
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for foot injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199758
Radiography foot
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for hand injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199759
Radiography hand
<0.1 mSv
☢
Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for hip injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199760
Radiography hip
1-10 mSv
☢☢☢
Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for humerus injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199761
Radiography humerus
<0.1 mSv
☢
Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for knee injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199762
Radiography knee
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for lumbar spine injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199763
Radiography lumbar spine
1-10 mSv
☢☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for lumbosacral spine injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199764
Radiography lumbosacral spine
1-10 mSv
☢☢☢
Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for radius and ulna injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199765
Radiography radius and ulna
<0.1 mSv
☢
Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for ribs injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199766
Radiography ribs


Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for shoulder injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199767
Radiography shoulder
<0.1 mSv
☢
Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for skull injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199768
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for thoracic spine injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199769
Radiography thoracic spine
1-10 mSv
☢☢☢
Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for thoracic and lumbar spine injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199770
Radiography thoracic and lumbar spine
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for tibia and fibula injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199771
Radiography tibia and fibula
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, concern for wrist injury based on clinical presentation or hx, no apparent neurological or skeletal or visceral injuries, initial imaging 3199772
Radiography wrist
<0.1 mSv
☢
Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, scalp bruises, initial imaging 3199774
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, head hematoma, initial imaging 3199775
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, skin injury to the head, initial imaging 3199776
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, complete spine hematoma, initial imaging 3199777
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography complete spine

0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, skin injury to the complete spine, initial imaging 3199778
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography complete spine

0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, cervical spine hematoma, initial imaging 3199779
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, skin injury to the cervical spine, initial imaging 3199780
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, cervical and thoracic spine hematoma, initial imaging 3199781
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography cervical and thoracic spine
1-10 mSv
☢☢☢
May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, skin injury of the cervical and thoracic spine, initial imaging 3199782
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography cervical and thoracic spine
1-10 mSv
☢☢☢
May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, skin injury to the lumbosacral spine, initial imaging 3199783
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography lumbosacral spine
1-10 mSv
☢☢☢
May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, lumbosacral spine hematoma, initial imaging 3199784
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography lumbosacral spine
1-10 mSv
☢☢☢
May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, skin injury to the thoracic spine, initial imaging 3199785
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography thoracic spine
1-10 mSv
☢☢☢
May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, thoracic spine hematoma, initial imaging 3199786
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography thoracic spine
1-10 mSv
☢☢☢
May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, thoracic and lumbar spine hematoma, initial imaging 3199787
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography thoracic and lumbar spine
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, skin injury to the thoracic and lumbar spine, initial imaging 3199788
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography thoracic and lumbar spine
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical findings suspicious for cervical spine CNS injury, scalp bruises, initial imaging 3199789
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, lumbar spine hematoma, initial imaging 3199790
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography lumbar spine
1-10 mSv
☢☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical findings suspicious for lumbosacral spine CNS injury, neuro signs or symptoms, initial imaging 3199791
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography lumbosacral spine
1-10 mSv
☢☢☢
May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical findings findings suspicious for lumbar spine CNS injury, neuro signs or symptoms, initial imaging 3199792
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography lumbar spine
1-10 mSv
☢☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical findings suspicious for thoracic and lumbar spine CNS injury, neuro signs or symptoms, initial imaging 3199793
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography thoracic and lumbar spine
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical findings suspicious for thoracic spine CNS injury, neuro signs or symptoms, initial imaging 3199794
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography thoracic spine
1-10 mSv
☢☢☢
May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical findings suspicious for cervical and thoracic spine CNS injury, neuro signs or symptoms, initial imaging 3199795
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography cervical and thoracic spine
1-10 mSv
☢☢☢
May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical findings suspicious for complete spine CNS injury, neuro signs or symptoms, initial imaging 3199796
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography complete spine

0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical findings suspicious for cervical spine CNS injury, neuro signs or symptoms, initial imaging 3199797
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical findings suspicious for skull CNS injury, neuro signs or symptoms, initial imaging 3199798
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical findings suspicious for CNS injury, skin injury to the lumbar spine, initial imaging 3199799
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography lumbar spine
1-10 mSv
☢☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, scalp bruises, initial imaging 3199801
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, skin injury to the head, initial imaging 3199802
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, head hematoma, initial imaging 3199803
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, complete spine hematoma, initial imaging 3199804
Radiography complete spine

0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, skin injury to the complete spine, initial imaging 3199805
Radiography complete spine

0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, skin injury to the cervical spine, initial imaging 3199806
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, cervical spine hematoma, initial imaging 3199807
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, skin injury to the cervical and thoracic spine, initial imaging 3199808
Radiography cervical and thoracic spine
1-10 mSv
☢☢☢
Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, cervical and thoracic spine hematoma, initial imaging 3199809
Radiography cervical and thoracic spine
1-10 mSv
☢☢☢
Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, lumbosacral spine hematoma, initial imaging 3199810
Radiography lumbosacral spine
1-10 mSv
☢☢☢
Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, skin injury to the lumbosacral spine, initial imaging 3199811
Radiography lumbosacral spine
1-10 mSv
☢☢☢
Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, thoracic spine hematoma, initial imaging 3199812
Radiography thoracic spine
1-10 mSv
☢☢☢
Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, skin injury to the thoracic spine, initial imaging 3199813
Radiography thoracic spine
1-10 mSv
☢☢☢
Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, skin injury to the thoracic and lumbar spine, initial imaging 3199814
Radiography thoracic and lumbar spine
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, thoracic and lumbar hematoma, initial imaging 3199815
Radiography thoracic and lumbar spine
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exams or findings suspicious for cervical CNS injury, scalp bruises, initial imaging 3199816
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, skin injury to the lumbar spine, initial imaging 3199817
Radiography lumbar spine
1-10 mSv
☢☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for CNS injury, lumbar spine hematoma, initial imaging 3199818
Radiography lumbar spine
1-10 mSv
☢☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical finding suspicious for lumbosacral spine CNS injury, neuro signs or symptoms, initial imaging 3199819
Radiography lumbosacral spine
1-10 mSv
☢☢☢
Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exams or findings suspicious for lumbar spine CNS injury, neuro signs or symptoms, initial imaging 3199820
Radiography lumbar spine
1-10 mSv
☢☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exams or findings suspicious for thoracic and lumbar CNS injury, neuro signs or symptoms, initial imaging 3199821
Radiography thoracic and lumbar spine
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exams or findings suspicious for thoracic spine CNS injury, neuro signs or symptoms, initial imaging 3199822
Radiography thoracic spine
1-10 mSv
☢☢☢
Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exams or findings suspicious for cervical and thoracic spine CNS injury, neuro signs or symptoms, initial imaging 3199823
Radiography cervical and thoracic spine
1-10 mSv
☢☢☢
Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exams or findings suspicious for complete spine CNS injury, neuro signs or symptoms, initial imaging 3199824
Radiography complete spine

0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exams or findings suspicious for cervical spine CNS injury, neuro signs or symptoms, initial imaging 3199825
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exams or findings suspicious for skull CNS injury, neuro signs or symptoms, initial imaging 3199826
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Physical abuse suspected, one or more physical exam or clinical findings suspicious for visceral injury, skin injury to the chest wall or trunk, initial imaging 3199828
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		May be appropriate
Radiography abdomen
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
Radiography pelvis
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical findings suspicious for visceral injury, chest wall or trunk hematoma, initial imaging 3199829
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		May be appropriate
Radiography abdomen
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
Radiography pelvis
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical findings suspicious for visceral injury, chest wall or trunk bruising, initial imaging 3199830
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		May be appropriate
Radiography abdomen
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
Radiography pelvis
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical findings suspicious for visceral injury, abdominal pain, initial imaging 3199831
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography abdomen
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Physical abuse suspected, one or more physical exam or clinical findings suspicious for visceral injury, skin injury to the chest wall or trunk, initial imaging 3199833
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually appropriate
Radiography abdomen
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually appropriate
Radiography pelvis
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical findings suspicious for visceral injury, chest wall or trunk hematoma, initial imaging 3199834
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually appropriate
Radiography abdomen
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually appropriate
Radiography pelvis
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical findings suspicious for visceral injury, chest wall or trunk bruising, initial imaging 3199835
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually appropriate
Radiography abdomen
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually appropriate
Radiography pelvis
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Physical abuse suspected, one or more physical exam or clinical findings suspicious for visceral injury, abdominal pain, initial imaging 3199836
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually appropriate
Radiography abdomen
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually appropriate
Radiography pelvis
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Physical abuse suspected, initial skeletal survey and CT head negative, follow up imaging within in 10-14 days 3199838
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Child with suspected physical abuse in same home, asymptomatic, initial imaging 3199840
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Child with physical abuse in same home, asymptomatic, initial imaging 3199841
Radiography skeletal survey
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US head
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
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