Chest radiographs in the pediatric emergency department for children < or = 18 months of age with wheezing.
There are no widely accepted predictors of pneumonia in wheezing infants and toddlers who present to the emergency department (ED). A 10-month retrospective review of ED visits of wheezing children < or = 18 months of age revealed the following chest radiograph (CXR) results: normal (21%), findings consistent with uncomplicated bronchiolitis or asthma (61%), focal infiltrates (18%), and other abnormalities (< 1%). Patients with focal infiltrates on CXR were more likely to have the following: a history of fever (p = 0.03, OR 2.1, 95% CI 1.0, 4.4), temperature > or = 38.4 degrees (p = 0.01, OR 2.5, 95% CI 1.1, 5.8) or crackles on examination (p < 0.0005, OR 3.9, 95% CI 1.7, 9.0). Selective use of CXRs has the potential to save health care dollars and limit unnecessary radiation.
Division of Emergency Medicine, Children's Hospital Medical Center, Cincinnati, Ohio 45229-2899, USA.
E M
EM
Mahabee-Gittens
D T
DT
Bachman
E D
ED
Shapiro
M D
MD
Dowd
D004636:Emergency Service, Hospital; D005260:Female; D005334:Fever; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010372:Pediatrics; D013902:Radiography, Thoracic; D012129:Respiratory Function Tests; D012135:Respiratory Sounds / Q000209:etiology*; D012189:Retrospective Studies