Staring this week, and continuing for the next five, we will be releasing new content supporting the key Pediatric Emergency Medicine recommendations of Choosing Wisely. I have partnered with world experts on the subject matter, and we’ve been developing this series over the past several months. There will be episodes of PEM Currents: The Pediatric Emergency Medicine Podcast, blog posts here on PEMBlog, articles from Don’t Forget the Bubbles, videos, and more! This seems like a lot for five straightforward ideas, but we hope that you will find ways to incorporate the evidence via this content, and learn how to have more informed discussions with patients and their families. You will no doubt be familiar with the following five recommendations – even if you’ve never heard of the Choosing Wisely organization before.

  • Do not obtain radiographs in children with bronchiolitis, croup, asthma, or first-time wheezing.
  • Do not obtain screening laboratory tests in the medical clearance process of pediatric patients who require inpatient psychiatric admission unless clinically indicated.
  • Do not order laboratory testing or a CT scan of the head for a pediatric patient with an unprovoked, generalized seizure or a simple febrile seizure who has returned to baseline mental status.
  • Do not obtain abdominal radiographs for suspected constipation
  • Do not obtain comprehensive viral panel testing for patients who have suspected respiratory viral illnesses.

Here is the schedule of content – one recommendation per week, for the next five weeks.

Do not obtain radiographs in children with bronchiolitis, croup, asthma, or first-time wheezing

Do not obtain screening laboratory tests in the medical clearance process of pediatric patients who require inpatient psychiatric admission unless clinically indicated

Do not order laboratory testing or a CT scan of the head for a pediatric patient with an unprovoked, generalized seizure or a simple febrile seizure who has returned to baseline mental status

Do not obtain abdominal radiographs for suspected constipation

Do not obtain comprehensive viral panel testing for patients who have suspected respiratory viral illnesses

Look, I know this is a lot, but I think these are very important, practice changing recommendations. I hope that you’ll at least check out something from this buffet of content, and learn something new about how to communicate with patients, families, and each other about tests that are not necessary to provide the very best care. You can learn more about Choosing Wisely here.

The Choosing Wisely Pediatric Emergency Medicine Recommendations

The Choosing Wisely Campaign Toolkit