Concerns have been raised too many unnecessary X-rays are being used on infants with common respiratory conditions like bronchiolitis and asthma.
Medical experts are calling for a re-think of the procedure’s use in children as part of the latest recommendations of the Choosing Wisely initiative launched on Monday by NPS MedicineWise.
Emergency department physician Dr Sarah Dalton, RACP Paediatrics & Child Health Division President, says in some cases X-rays are happening “too frequently”, placing the child at harm.
“Unfortunately what we see is that so many of these children that come in to emergency departments with breathing problems and are having chest X-rays that doesn’t really change the treatment that we offer but it does put them at risk of the radiation that is associated with the X-ray and that is what we are trying to stop,” Dr Dalton told AAP.
Dr Dalton said very rarely does an X-ray change the treatment of a child with typical bronchiolitis – a common condition in babies where they get a virus that makes it hard to breathe.
An X-ray should always be ordered if a doctor suspects pneumonia, a complication of bronchiolitis, she said.
“But there really is only a very small number of children who when I listen to their chest I think they do need a chest X-ray, in most situations when we examine children with this kind of problem there is no indication of it being pneumonia and therefore they don’t really need the X-ray,” Dr Dalton told AAP.
“One of the studies showed that if you do 100 X-rays for children with bronchiolitis it will only change the treatment course for one child.”
Dr Dalton is calling on her fellow doctors to “pause for a second” before recommending an X-ray.
“The challenge is working out when they’re needed and when they’re not,” she said.
“For any parents who might be concerned about the idea that ‘less can sometimes be more’, I would say to them we want to make sure we are only ordering a test when it is medically beneficial for your child.”
The initiative is also advising against the use of X-rays for lower back pain in adults.
Another important focus of the newly-released Choosing Wisely recommendations is getting people back to work and doctors have asked not to certify a patient as totally unfit for work unless clinically necessary.
“Where appropriate we are encouraging willing patients to continue working in some capacity as part of their overall healthcare management,” said Associate Professor Peter Connaughton, President of the Australasian Faculty of Occupational and Environmental Medicine.
Doctors have also been warned about prescribing opioids for the treatment of acute or chronic pain.