Tests and procedures on hospitalized kids: first, do no harm
The program recommendations starts small with 5 simple, concrete guidelines. All of these have been or are common practices of dubious or no benefit.
- Do not order chest x-rays on children with straightforward asthma or bronchiolitis.
- Do not use steroids in children less than 2 years of age with pneumonia
- Do not use bronchodilators (like albuterol) in children with bronchiolitis
- Do not routinely treat gastro-esophageal reflux in infants with acid suppression therapy (like Zantac or Prilosec)
- Do not use a pulse oximeter machine on children who are not receiving oxygen therapy. (This is a device that goes on a finger or a toe and measures oxygen in the blood continuously.)
These are all very sensible guidelines, but they’re only a beginning. The idea is not to forbid doctors from doing these things, but rather to make us think twice about ordering them to make sure they make sense for a particular patient. We don’t want to add cost, and certainly not risk, without adding any benefit.
Sachin on 