{"id":314,"date":"2014-04-03T20:17:53","date_gmt":"2014-04-03T20:17:53","guid":{"rendered":"http:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/?p=314"},"modified":"2017-08-21T12:55:09","modified_gmt":"2017-08-21T12:55:09","slug":"primary-care-corner-with-geoffrey-modest-md-test-to-avoid-in-kids","status":"publish","type":"post","link":"http:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/2014\/04\/03\/primary-care-corner-with-geoffrey-modest-md-test-to-avoid-in-kids\/","title":{"rendered":"Primary Care Corner with Geoffrey Modest MD: Test to avoid in kids"},"content":{"rendered":"<p>choosing wisely came out with 10 tests\/treatments that pediatricians\/fam practice\/ER providers should question (see <a href=\"http:\/\/www.choosingwisely.org\/wp-content\/uploads\/2014\/03\/AAP10things-march2014.pdf\">here<\/a>). nothing very surprising.<\/p>\n<p>1. not use antibiotics for apparent viral infection (sinusitis, pharyngitis, bronchitis) &#8212; still used too much, though rates have fallen<br \/>\n2. not give cough\/cold remedies to kids under 4<br \/>\n3. not do CT for minor head injuries. clinical observation often sufficient and less radiation.<br \/>\n4. not do neuroimaging in kid with simple febrile seizure<br \/>\n5. not routinely do abdominal CT in kids with abdominal pain (again, too much radiation and often risks&gt;benefits)<br \/>\n6. no advantage to high dose steroids for prevention\/treatment of bronchopulmonary dysplasia in premies<br \/>\n7. not order IgE screening panels for food allergies without reasonable medical history (too many false positives: eg, 8% of population test positive for peanut allergy, but 1% are really allergic)<br \/>\n8. not use acid blockers or motility agents (eg metoclopromide) routinely in reflux (GER). GER is normal in infants and should not be treated unless affecting growth\/resp sx. not usually necessary to do GI tract imaging to diagnose.<br \/>\n9. not do surveillance urine cultures to detect asymptomatic bacteruria<br \/>\n10. not routinely use infant home apnea monitors to prevent SIDS (may be reasonable if infant at risk for apnea or cardiovasc events).<\/p>\n<p>geoff<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Test to avoid in kids [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"http:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/2014\/04\/03\/primary-care-corner-with-geoffrey-modest-md-test-to-avoid-in-kids\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":148,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[14283],"tags":[],"class_list":["post-314","post","type-post","status-publish","format-standard","hentry","category-archive"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"http:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts\/314","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/users\/148"}],"replies":[{"embeddable":true,"href":"http:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/comments?post=314"}],"version-history":[{"count":0,"href":"http:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts\/314\/revisions"}],"wp:attachment":[{"href":"http:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/media?parent=314"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/categories?post=314"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/tags?post=314"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}