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Does anyone examine the patient, get blood work and call the surgeon with clinical suspicion with laboratory data consistent with appendicitis, and nothing else?Does anyone place in observation, call the surgeon for equivocal exams and lab data?Todd Z


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-------- Original message --------From: Christine Darr <[log in to unmask]> Date: 7/14/16  3:36 PM  (GMT-06:00) To: [log in to unmask] Subject: Re: RLQ Pain after 5pm in your ED 
We have 24/7 ultrasound available at all of our sites.   

Christine D. Darr, MD, FAAP, FACEP
Medical Director, Pediatric Division
CarePoint, PC
Medical Director, Rocky Mountain Hospital for Children Emergency Department
Phone 303-436-2723
Mobile 303-748-6200
Fax 303-436-2710
[log in to unmask]      

-----Original Message-----
From: Pediatric Emergency Medicine Discussion List [mailto:[log in to unmask]] On Behalf Of Frank Overly, MD
Sent: Thursday, July 14, 2016 10:18 AM
To: [log in to unmask]
Subject: RLQ Pain after 5pm in your ED

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.

thanks

Frank

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

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