Publication/Presentation Date

11-1-2020

Abstract

BACKGROUND: We hypothesize that in pediatric trauma patients, CT scans after normal chest x-rays do not add information that alters clinical decision making.

METHODS: A retrospective review of trauma patients < 15 years with chest imaging evaluated at a pediatric trauma center between 1/2013 and 6/2019 was performed. Imaging was reviewed for significant findings that could affect care. A guideline was established in January 2017 which emphasized x-rays prior to CTs and no CTs after normal x-rays. A prospective review was performed from 1/2017-6/2019. Pre and post guideline groups were compared.

RESULTS: From 2013 to 2016, 246 patients met inclusion. 29.5% had a chest CT after a normal x-ray, only 1.8% (1/57) had a significant result. From 2017 to 2019, 188 patients were reviewed post guideline; only 9.4% received a CT after normal x-ray, of which 6.3% (1/16) were significant. Neither changed clinical management.

CONCLUSIONS: Chest CT following normal chest x-ray does not change clinical management in pediatric trauma patients. Monitoring and education following guideline implementation improves long term outcomes.

Volume

220

Issue

5

First Page

1327

Last Page

1332

ISSN

1879-1883

Disciplines

Education | Medical Education

PubMedID

32928539

Department(s)

Department of Education, Department of Pediatrics, Department of Surgery

Document Type

Article

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