Avoid x-rays in children who present with bronchiolitis, croup, asthma, or first-time wheezing, urged the American Academy of Pediatrics (AAP) in a newly published list of recommendations issued jointly with the “Choosing Wisely” campaign. The two have collaborated in creating a list of five common emergencies for which children frequently present to emergency care where testing may be unnecessary in order to prevent pain, exposure to harmful radiation, increased length of stay in the ED and cut down on treatment costs.^1,2

The other recommendations include avoiding lab tests or CT scan head in children who present with unprovoked, generalized seizure or a simple febrile seizure who have returned to baseline mental status, abdominal x-rays in children with suspected constipation and comprehensive viral panel testing in children suspected to have respiratory viral infections.

Children who need hospitalization for psychiatric conditions should also not be subjected to screening laboratory tests, unless clinically indicated.

References

1. AAP News Release, Dec. 1, 2022. Available at: https://www.aap.org/en/news-room/news-releases/aap/2022/choosing-wisely-five-things-physicians-and-patients-should-question-in-the-practice-of-pediatric-emergency-medicine/.
2. https://www.choosingwisely.org/societies/american-academy-of-pediatrics-section-on-emergency-medicine-and-the-canadian-association-of-emergency-physicians/, December 1, 2022.