Emergency Provider Use of Plain Radiographs in the Evaluation of Pediatric Constipation
| Autor: | Eileen J. Klein, Ryan Kearney, Miranda C. Bradford, Todd C. Edwards |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Abdominal pain medicine.medical_specialty Constipation Cross-sectional study Radiography MEDLINE 03 medical and health sciences 0302 clinical medicine Professional-Family Relations 030225 pediatrics Surveys and Questionnaires medicine Humans 030212 general & internal medicine Practice Patterns Physicians' Child business.industry Practice patterns Pediatric Emergency Medicine General Medicine Abdominal Pain Cross-Sectional Studies Pediatrics Perinatology and Child Health Emergency Medicine Physical therapy Plain radiographs Female medicine.symptom business |
| Zdroj: | Pediatric emergency care. 35(9) |
| ISSN: | 1535-1815 |
| Popis: | More than half of children evaluated as outpatients for abdominal pain are diagnosed with constipation. X-ray use in this scenario is variable: less than 5% in clinic settings, greater than 70% in emergency departments. X-rays increase misdiagnosis rate, remain costly, and involve radiation exposure.The aim of this study was to assess the use of plain radiographs by pediatric emergency medicine (PEM) providers in the diagnostic evaluation and management of pediatric constipation.A cross-sectional survey of PEM providers was performed. Survey participants were subscribers to the American Academy of Pediatrics Section on Emergency Medicine Listserv. To assess diagnostic and therapeutic approaches, participants were presented a case of pediatric constipation meeting Rome III clinical criteria. Participants also categorized frequency of x-ray use, reasons for obtaining, estimated diagnostic utility, and elements of institutional standard approach. Descriptive statistical analyses were performed.Three hundred five of 1272 Listserv members (24%) responded. Ninety-nine percent elected to treat for constipation in a case meeting Rome III clinical criteria; one third (31%) would obtain plain radiographs for this same scenario. Plain radiographs were viewed as somewhat (59%) or minimally (29%) value-added in the evaluation of suspected pediatric constipation. Obtaining family buy-in (44%) was the most common reason for utilizing plain radiographs. Frequency of use varied across geographic regions and with participant and hospital characteristics.This survey suggests that many PEM providers obtain radiographs to convince families of the diagnosis of constipation. This is not a viable management plan given the risks of radiation as well as costs. There remains room for improvement as we attempt to reduce use of radiation in the evaluation of common pediatric illnesses. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|