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Good morning! We started using US for diagnosis of appendicitis about 18
months ago. We have a high volume pediatric ED, 50K, in a community
hospital. Our issue is that the expertise of the US techs for identifying
the appendix has not improved. Sensitivity about 50%, and identifying the
appendix about 15% of the time.  Has anyone had any luck with any specific
training programs for their techs in this area.
Thanks,
Donna Bhisitkul, MD
Medical Director, Pediatric ED
Lakeland Regional Health

On Thu, Jul 14, 2016 at 10:55 PM, Ahmad, Fahd <[log in to unmask]>
wrote:

> Yes – we do that frequently.  Usually when the US is equivocal.  ☺
> However we don’t have 24 hour US coverage, so we do that for every patient
> at night.
>
>
>
> On 7/14/16, 7:08 PM, "Pediatric Emergency Medicine Discussion List on
> behalf of trzim29" <[log in to unmask] on behalf of
> [log in to unmask]> wrote:
>
> 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
>
>
> Sent from my Verizon, Samsung Galaxy smartphone
> -------- 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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