13^th World Pediatric Congress

Chest X-Rays (CXR) are being increasingly used in pediatric A+E departments as a diagnostic tool at the expense of unnecessary exposure to radiation, use of resources, long waiting times in ED, and cost. There is little consensus with regards to which patient should receive a CXR. We carried out a retrospective study looking at 49 patients who received a CXR at a district general hospital’s pediatric A+E department for medical indications over a period of one month. We excluded foreign body ingestion and trauma. 21/49 patients were discharged having received a CXR, only one was positive. Out of the 20/21 negative CXR in the discharged cohort, 8 were treated with oral antibiotics regardless. 28/49 patients were admitted to hospital and 20/28 of these CXR were negative. In none of the cases did the CXR make a positive difference in giving antibiotics to the child. The decision to admit was based on the clinical status of the child rather than CXR findings as was the decision to discharge. The decision for antibiotics should be made clinically with history and examination findings. In conclusion we could reduce XR burden by targeting children in A+E who are well for discharge, whose diagnosis can be made clinically by introducing a guideline in A+E.