Chest Radiographs in the Pediatric Emergency Department for Children ≤18 Months of Age with Wheezing

Abstract

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 ≤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 ≥38.4° (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. Clin Pediatr. 1999;38:395-399

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