scholarly journals Long-term changes in computed tomography and ultrasound utilization in a pediatric emergency department

2018 ◽  
Vol 5 (1) ◽  
pp. 35-42
Author(s):  
Ikwan Chang ◽  
Jae Yun Jung ◽  
Young Ho Kwak ◽  
Do Kyun Kim ◽  
Jin Hee Lee ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Long Term Changes

Use of Head Computed Tomography (CT) in the Pediatric Emergency Department in Evaluation of Children With New-Onset Afebrile Seizure

2018 ◽  
Vol 33 (11) ◽  
pp. 708-712 ◽  
Author(s):  
Aravindhan Veerapandiyan ◽  
Akilandeswari Aravindhan ◽  
James Huynh Takahashi ◽  
Devorah Segal ◽  
Keith Pecor ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Pediatric Emergency ◽  
Cranial Computed Tomography ◽  
Seizure Type ◽  
Pediatric Emergency Department ◽  
Seizure Duration ◽  
Chi Square ◽  
Head Ct ◽  
Afebrile Seizure

Objective: Cranial computed tomography (CT) is not recommended in the routine evaluation of children with first afebrile seizure due to its low yield. The objective was to assess the current practice in our pediatric emergency department regarding the use of head CT in children with first afebrile seizure and to identify the factors that lead to ordering a head CT. Methods: Medical records of patients between 1 month and 18 years old evaluated at our emergency department for presentation of first afebrile seizure between 2010 and 2014 were retrospectively reviewed. Data extracted include age, gender, seizure type, single or multiple seizures at presentation, seizure duration, predisposing conditions to seizures (ie, history of developmental delay), and whether a head CT was performed. Contingency tables with chi-square analyses were used to determine which variables were associated with increased use of head CT. Results: Of 155 patients (88M/67F) included in the study, 72 (46.5%) underwent head CT and only 3 had clinically significant findings that did not require acute management. There were no differences in CT use by age, sex, seizure type, seizure number, seizure risk factors, or findings on physical examination. Head CT was performed more frequently in cases with seizures ≥5 minutes and unknown seizure duration ( P = .04). Conclusion: Despite existing evidence, the emergent head CT rate was high in our cohort. Children with seizure duration of ≥5 minutes or of unknown duration were more likely to undergo head CT in our emergency department.

Undifferentiated Abdominal Pain in Children Presenting to the Pediatric Emergency Department

2019 ◽  
Vol 58 (11-12) ◽  
pp. 1212-1223
Author(s):  
Brendan R. Harris ◽  
Sri S. Chinta ◽  
Ryan Colvin ◽  
David Schnadower ◽  
Phillip I. Tarr ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Abdominal Pain ◽  
Laboratory Tests ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Laboratory Results ◽  
Ed Visits

Although common, little is known about the characteristics and management of undifferentiated abdominal pain (UAP) in the pediatric emergency department (ED). This study was a 12-month retrospective study for “abdominal pain” ED visits. Patients without an identifiable diagnosis were categorized as “UAP,” while others with identified disease processes were categorized as “structural gastrointestinal diagnosis (SGID).” We included 2383 (72%) visits with 869 (36.5%) UAP visits and 1514 (63.5%) SGID visits. SGID patients had more laboratory tests (811 [53.6%] vs 422 [48.6%], P = .0186), and often had multiple tests performed (565 [69.7%] vs 264 [62.6%], P = .0116). Computed tomography and ultrasound scans were more common in SGID (computed tomography: 108 [7.1%] vs 27 [3.1%], P = .0004; ultrasound: 377 [24.9%] vs 172 [19.9%], P = .0044), and laboratory results (white blood cell count, hemoglobin, albumin, C-reactive protein) were abnormal at significantly higher rates. Analyses revealed the duration of pain as primary covariate in variance of pain etiology. Clinical features, such as duration of pain, may be augmented by laboratory tests to facilitate recognition of UAP in the ED.

Utilization of computed tomography imaging in the pediatric emergency department

2019 ◽  
Vol 50 (4) ◽  
pp. 470-475 ◽  
Author(s):  
Daniel Jack Frush ◽  
Clayton W. Commander ◽  
Terry Scott Hartman ◽  
Aaron Kyle Cecil ◽  
Brian Douglas Handly ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Computed Tomography Imaging ◽  
Tomography Imaging
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