The American Academy of Pediatrics, the American College of Emergency Physicians, and American College of Radiology have issued a joint policy statement offering guidelines “for institutions and medical professionals who care for children to make the best use of advanced imaging in the emergency department by weighing benefits and risks.”
Jennifer R. Marin, the lead author of the policy statement, writes that there has been “a dramatic increase” in the use of studies of advanced imaging, despite the fact that many of those studies are “considered to be of low value.” Aisha Terry, president of ACEP, touts these guidelines as a means for reminding clinicians to “routinely weigh any risk associated with pediatric imaging against the benefits.” She also says that “adopting standardized approaches to evaluation and diagnosis using evidence-based guidelines can improve care coordination as well as shared decision-making between clinicians and families.”
The report provides condition-specific imaging recommendations, including “clinical guidelines and pathways from several children’s hospitals that can be useful for providers at the point of care.” The associations recommend that emergency departments “ensure that appropriate computed tomography protocols and parameters are used for pediatric patients;” “strive to provide ultrasound services as first-line imaging when indicated, such as for appendicitis or nephrolithiasis;” and “develop policies for imaging consultation with a pediatric radiologist, general radiologist with expertise in pediatric imaging or pediatric subspecialist to minimize transfers that may require only imaging review.”
