Recommendations issued for advanced imaging for pediatric patients in ED

In a policy statement issued by the American Academy of Pediatrics and published online June 27 in Pediatrics, recommendations are presented for optimizing advanced imaging use for pediatric patients in the emergency department.

Jennifer R. Marin, M.D., from the University of Pittsburgh School of Medicine, and colleagues provide guidelines for institutions and those who care for children to optimize the use of advanced imaging in the emergency department setting.

According to the authors, emergency departments that provide pediatric care should ensure appropriate imaging resources are available to meet the needs of children or have protocols and guidelines in place for transfer to a pediatric center.

Primary care and emergency physicians, physician assistants, and nurse practitioners should optimize advanced imaging by familiarizing themselves with pediatric imaging resources available at local emergency departments and use this information to decide where to refer patients; discuss and defer advanced imaging in children in whom the results of imaging will not alter management prior to and during transfer; use shared decision-making prior to ordering imaging, when appropriate; and use evidence-based guidelines and protocols to minimize potentially unnecessary imaging.

The authors also address condition-specific imaging for multiple condition, including seizures, pediatric stroke, trauma, and child abuse.

"Many imaging studies are considered to be of low value, meaning the risks outweigh the benefits," Marin said in a statement. "More studies aren't necessarily better and it is important that clinicians consider factors, including the radiation exposure from computed tomography and false-positive and incidental findings that increase downstream testing."

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