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 Vol. 18 No. 2, August 2007
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AAP Grand Rounds 18:14-15 (2007)
© 2007 American Academy of Pediatrics

EMERGENCY MEDICINE

Routine Chest Radiographs in Acute Bronchiolitis Are Not Necessary

Source: Schuh S, Lalani A, Allen U, et al. Evaluation of the utility of radiography in acute bronchiolitis. J Pediatr. 2007;150:429–433; doi:10.1016/j.jpeds.2007.01.005[CrossRef][Medline]

The first 20% of the full text of this article appears below.

Bronchiolitis is a frequent cause of respiratory distress and hospitalization in young infants. Many patients with typical presentation of bronchiolitis are evaluated with chest radiography to identify complications or clinical conditions that can mimic bronchiolitis. Researchers from the Hospital for Sick Children in Toronto, Ontario, Canada performed a prospective cohort study of children aged 2 to 23 months who were evaluated in their pediatric emergency department with signs and symptoms of bronchiolitis to determine the utility of routine chest radiographs and their effect on the decision to prescribe antibiotics. Patients were included if they were previously healthy and had typical symptoms of bronchiolitis (nontoxic appearance with coryza, cough, and respiratory distress with wheezing). Patients with a history of wheezing and/or with a concurrent diagnosis of otitis media were excluded. After initial evaluation by emergency physicians, patients were treated with two to three consecutive doses of albuterol nebulizations. Prior to the chest radiograph, the treating physician indicated his/her intended use of antibiotics and disposition. After review of the radiographs . . . [Full Text of this Article]

Ronald I. Paul, MD, FAAP1 and Miles Weinberger, MD, FAAP2
1 Pediatric Emergency Medicine, University of Louisville, Louisville, KY
2 Pediatric Allergy and Pulmonary Division, University of Iowa, Iowa City, IA