Teeny tiny pedi ED in Manchester NH.
24/7 high quality US
Initially lots of push back and pressure to scan. Improved with arrival of pedi surgery and engagement of adult surgeons and improvement of techs. Now we very seldom CT.
> On Jul 14, 2016, at 6:38 PM, Kellie Williams <[log in to unmask]> wrote:
> In our children's hospital (in a big city) we have 24/7 CT scan. This is my
> first position after fellowship. When I first came I tried ordering US for
> appendicitis. I received numerous phone calls stating the US techs were not
> "good enough" to find the appendix. One tried tech even told my pts, mother
> that US is not used to find the appendix and I was doing something wrong.
> Then I got a lecture from one of the radiologist explaining to me that this
> is the REAL WORLD not academics therefore stop ordering US and use the CT.
> Its pretty sad that even when kids come from an OSH with an US concerning
> for an appy our surgeons want us to scan them. Our group has tried numerous
> times to educate both the rads, and the surgeons regarding this issue.
> Showing them numerous articles and they don't care. Sad really. It makes me
> angry ordering all these CTs for something that can easily be diagnosed
> with an US.
> On Thu, Jul 14, 2016 at 11:17 AM, Frank Overly, MD <[log in to unmask]>
>> I know this has been discussed, but it has been several years when I
>> search the archives. We are getting ready to sit down with our surgeons
>> and radiologists (again) to discuss standard of care for evaluation of
>> pediatric patients with RLQ pain. Our institution only has US for r/o appy
>> until 5pm and after that we are challenged with how to evaluate these
>> patients. We rarely CT, only occasionally MRI, frequently either admit for
>> US next day or send home for US next day.
>> I am curious to know what others are doing, to hopefully strengthen our
>> argument for either US 24/7 or possibly MRI when US not available.
>> Appreciate any info.
>> Frank L. Overly, MD, FAAP
>> Associate Professor
>> Emergency Medicine and Pediatrics
>> Alpert Medical School of Brown University
>> Medical Director
>> Pediatric Emergency Department
>> Hasbro Children’s Hospital
>> For more information, send mail to [log in to unmask] with the
>> message: info PED-EM-L
>> The URL for the PED-EM-L Web Page is:
> For more information, send mail to [log in to unmask] with the message: info PED-EM-L
> The URL for the PED-EM-L Web Page is:
For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is: