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Bronchiolitis
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Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
Filling the abdomen of a trauma patient with oral contrast before potential surgery is undesirable. New Concepts in Radiology: Update Course 2017 · 28:32
New Concepts in Radiology: Update Course 2017
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At the 5th Annual Stay Current Pediatric Surgery Update Course in 2017, Dr. Mike Rubin discusses new concepts in radiology. He includes discussion on risk of radiation-induced cancer, CT imaging for airway foreign body, timing ofair enemas
video40:58 · Sep 2018
Rapid Microbiological Testing Impact on Infectious Disease Management in Emergency Medicine
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Moderado por, Dr. Javier Gonzalez del Rey (Profesor de Pediatria y Associate Chair for Medical Education, Cincinnati Children’s Hospital Medical Center.
Tema de discusiòn: Impacto de los test microbiológicos rápidos en el manejo de la pa
video46:06 · Nov 2022
Filtering misinformation and educating families takes significant clinician time, contributing to emergency department overcrowding with patients who do not meet admission criteria. — María Serrano, Reunión de la Medicina de Emergencia - Impacto de las redes sociales (RRSS) en la práctica clínica en urgencias · 40:30
Reunión de la Medicina de Emergencia - Impacto de las redes sociales (RRSS) en la práctica clínica en urgencias
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Moderado por, Javier Gonzalez del Rey, MD, MEd – Cincinnati Children’s Hospital Medical Center.
Tema de discusiòn: Impacto de las redes sociales (RRSS) en la práctica clínica en urgencias
Fecha y Hora: 13 de Noviembre de 2023, 10:00 AM, H
video48:08 · Nov 2023
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New Concepts in Radiology: Update Course 2017
Airport X-ray scanners deliver 11 nanosieverts of radiation, which is 11 billionths of a sievert.
clinical0:00 ↗
Background radiation from radon and cosmic sources is approximately 3 millisieverts per year.
clinical0:00 ↗
A typical pediatric chest CT delivers 1 to 10 millisieverts, often 1-3 mSv, comparable to one year of background radiation.
clinical0:00 ↗
CT radiation exposure in pediatric institutions has decreased dramatically with new image-gently criteria and technology improvements.
clinicalDan2:04 ↗
Data on childhood malignancy risk from childhood CT scans (not atomic bomb data) increased one speaker's concern about CT radiation.
opinionDavid2:40 ↗
The 2011 American Association of Physicists in Medicine position statement concluded that risks of medical imaging at 50-100 millisieverts are low and may be non-existent.
Host summaryThe host summarizing the discussion — not the host's own clinical position4:51 ↗
AAPM stated that predictions of cancer risk from low-dose imaging in the media are not scientifically supported and may cause patients to forgo beneficial CT scans.
Host summaryThe host summarizing the discussion — not the host's own clinical position4:51 ↗
Some pediatric institutions now perform sinus CT at doses lower than conventional sinus radiographs.
clinical4:51 ↗
Sensitivity and specificity of inspiration-expiration films for airway foreign bodies are imperfect.
clinical7:36 ↗
Physical examination does not reliably exclude airway foreign body; even normal exam does not rule it out.
clinical8:10 ↗
A foreign body of any significance would be very unusual to have absolutely no findings on physical exam.
opinionSteven Rothenberg9:51 ↗
In one study, 30-50% of patients with confirmed airway foreign bodies had normal chest radiographs.
Host summaryMike summarizing the discussion — not the host's own clinical position10:22 ↗
Decubitus views for foreign body detection did not improve sensitivity and decreased specificity compared to standard radiographs.
Host summaryMike summarizing the discussion — not the host's own clinical position10:22 ↗
Expiration views improved sensitivity for foreign body detection but did not improve specificity.
Host summaryMike summarizing the discussion — not the host's own clinical position10:22 ↗
In a 2004 study of 23 patients, low-dose CT detected all 15 foreign bodies confirmed at bronchoscopy with no discordance.
Host summaryMike summarizing the discussion — not the host's own clinical position10:22 ↗
Volumetric chest CT for foreign body can be performed without sedation or IV contrast, and motion artifact does not prevent foreign body visualization.
clinicalMike10:22 ↗
At Mike's institution, 12-15 patients have undergone volumetric CT for suspected foreign body with 100% concordance between CT and bronchoscopy when bronchoscopy was performed.
clinicalMike10:22 ↗
CT can show air trapping distal to a foreign body and pinpoint the exact bronchial location, aiding bronchoscopic planning.
clinicalMike15:18 ↗
A chest radiograph delivers approximately 0.02 millisieverts; 50 chest X-rays equal one millisievert.
clinical16:44 ↗
CT can visualize vegetable matter, peanuts, and most radiolucent foreign bodies because they opacify the air column; only objects with the same density as air throughout would be invisible.
clinicalMike19:52 ↗
Families and consultants frequently express concern about CT radiation and anesthesia risk, requiring repeated explanations even when physicians believe risks are low.
opinionDan21:26 ↗
Performing bronchoscopy in a child with respiratory symptoms (who may have bronchiolitis or asthma rather than foreign body) carries higher anesthetic risk.
clinical18:02 ↗
Most institutions perform delayed second attempts at intussusception reduction after initial failure, unless peritoneal signs or perforation are suspected.
Host summaryThe host summarizing the discussion — not the host's own clinical position22:55 ↗
If an intussusceptum shows no movement during the first reduction attempt (especially if located in sigmoid colon or splenic flexure), second attempts are usually unsuccessful.
clinicalMike23:53 ↗
If the intussusceptum moves to the ileocecal valve on first attempt, second attempts are usually successful.
clinicalMike23:53 ↗
Delay between first and second reduction attempts ranges from 15 minutes to overnight across institutions, with most around 1-3 hours; success rates are approximately 50% regardless of delay duration.
clinicalMike25:40 ↗
Good trauma studies show oral contrast is not needed for abdominal CT in trauma.
Host summaryThe host summarizing the discussion — not the host's own clinical position28:32 ↗
Filling the abdomen of a trauma patient with oral contrast before potential surgery is undesirable.
opinion28:32 ↗
Oral contrast is not used for trauma or appendicitis at most institutions; selective use includes partial small bowel obstruction.
Host summaryThe host summarizing the discussion — not the host's own clinical position28:51 ↗
Fluid-filled bowel loops serve as a natural contrast agent on CT, making oral contrast unnecessary in most cases.
clinical29:18 ↗
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