Evaluation of an initiative to reduce radiation exposure from CT to children in a non-pediatric-focused facility.

We would like to share our experience of reducing pediatric radiation exposure. Much of the recent literature regarding successes of reducing radiation exposure has come from dedicated children's hospitals. Nonetheless, over the past two decades, there has been a considerable increase in CT imaging of children in the USA, predominantly in non-pediatric-focused facilities where the majority of children are treated.

Bedside upper gastrointestinal series in critically ill low birth weight infants.

Background: The upper gastrointestinal (UGI) series is the preferred method for the diagnosis of malrotation. A bedside UGI technique was developed at our institution for use in low birth weight, critically ill neonates to minimize the risks of transportation from the neonatal intensive care unit (NICU) such as hypothermia and dislodgement of support lines and tubes.

Objective: To determine the ability of a bedside UGI technique to identify the position of the duodenojejunal junction (DJJ) in low birth weight, critically ill infants in the NICU.

The predictive value of a normal radiographic anterior fat pad sign following elbow trauma in children.

Objective: The purposes of this study were to describe the characteristics of a normal anterior fat pad (AFP) and to determine the association between a normal AFP and the absence of fracture.

Methods: A prospective cohort of children aged 1 to 18 years with elbow trauma underwent radiographic examination. All patients received standard orthopedic management and follow-up 7 to 14 days after injury.

CT can reduce hospitalization for observation in children with suspected appendicitis.

Background: There are no clinical or laboratory tests that can eliminate the possibility of appendicitis in a child with abdominal pain that suggests the diagnosis. The standard of care is to admit these children to the hospital for observation. More than twice as many children hospitalized for abdominal pain suggesting appendicitis are subsequently sent home after observation compared to those who undergo appendectomy.

What can we learn from chest radiographs in hypoxemic asthmatics?

Background: Chest radiographs (X-rays) are frequently obtained on children with asthma exacerbations who remain hypoxemic after therapy even though their utility has not been evaluated.

Objective: To compare X-rays in hypoxemic and non-hypoxemic asthmatic children.

Methods: Over 21 months, X-rays were obtained on all persistently hypoxemic asthmatics (1-17 years, oxygen saturation <93% in room air), and some non-hypoxemic asthmatics.

Is a complete trauma series indicated for all pediatric trauma victims?

Objective: Trauma series radiographs (ie, lateral cervical spine, anteroposterior chest, and anteroposterior pelvis) are routinely recommended for victims of multiple trauma. However, the utility of the chest and pelvic radiographs has never been adequately evaluated. The purpose of this study is to determine whether clinical findings alone predict the results of these radiographs.