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The appropriate use of CT: quality improvement and clinical decision-making in pediatric emergency medicine

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Abstract

An increasing number of patients presenting to a shrinking number of hospital emergency departments has contributed to challenges to providing high-quality care, specifically care that is safe, efficient and effective. These challenges are magnified by trends in CT utilization with uncertain implications for care delivery. The utility of CT poses challenges to the pediatric emergency medicine physician to balance risk with potential benefit. We describe the process of evidence-based clinical decision-making to define the appropriate use of CT studies. Strategies for minimizing CT utilization in managing appendicitis, traumatic brain injury and cervical spine injuries are described. Clinical scores, clinical decision rules and evidence-based guidelines can assist the clinician in providing high-quality care through effective utilization of CT.

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Disclaimer

The supplement this article is part of is not sponsored by the industry. Dr. Macias and Dr. Sahouria have no financial interest, investigational or off-label uses to disclose.

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Authors and Affiliations

  1. Emergency Department, Texas Children’s Hospital, 6621 Fannin St., MC 1–1481, Houston, TX, 77030, USA

    Charles G. Macias

  2. Department of Pediatrics, Section of Emergency Medicine, Baylor College of Medicine, 6621 Fannin St., MC 1–1481, Houston, TX, 77030, USA

    Charles G. Macias & Julieanna J. Sahouria

  3. Center for Clinical Effectiveness, Houston, TX, USA

    Charles G. Macias & Julieanna J. Sahouria

Authors
  1. Charles G. Macias
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  2. Julieanna J. Sahouria
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Correspondence to Charles G. Macias.

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Macias, C.G., Sahouria, J.J. The appropriate use of CT: quality improvement and clinical decision-making in pediatric emergency medicine. Pediatr Radiol 41 (Suppl 2), 498 (2011). https://doi.org/10.1007/s00247-011-2102-7

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