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About Robert Cloutier, MD MCR

Associate Professor of Emergency Medicine and Pediatrics
Co-Director Pediatric Emergency Medicine Fellowship
Assistant Program Director Emergency Medicine Residency
Oregon Health and Science University
Portland, Oregon
25 01, 2016

PEM Pearls: Assessing Radiation Risk in Children Getting CT Imaging – Managing Risk and Making Medical Decisions

2017-10-26T14:34:22+00:00

Radiation risk in children getting CT imaging The Case: A 5 year old girl presents to the ED with approximately 24 hours of suprapubic and RLQ abdominal pain. Vital signs are: Temp 38.2 C, HR 110, RR 19, BP 100/60, Oxygen Sat 100% on room air. She has vomited twice but has not had diarrhea. She had a history of constipation a year ago that has resolved and mother denies any urinary symptoms or history of UTI’s. The patient is quiet but nontoxic appearing. Your abdominal exam notes mild to moderate RLQ tenderness but no rebound and normal bowel sounds. You order a urinalysis, which is negative and a RLQ US which ‘does not visualize the appendix’. Your suspicion for possible appendicitis is still intermediate; however, now the patient states she is “a little hungry”. Should you order a CT of the abdomen and pelvis? Uuugh!

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