Radiology practices in emergency departments associated with pediatric residency training programs

To examine the current radiology practices in academic emergency departments (EDs) serving children, a postal survey was done of 116 directors of EDs that serve as routine teaching sites for pediatric residents. One hundred three ED directors (89%) completed the survey, representing 75 pediatric-only EDs and 28 combined pediatric/adult EDs. Thirty-four of these EDs offer a pediatric emergency medicine fellowship. Hospitals were self-categorized as children's hospitals in 41 and non-children's hospitals in 62. Radiologists immediately read every study in 8% of the 103 EDs. Overall, 66% of the EDs have a radiology resident in-house overnight, which is significantly more likely in non-children's hospitals than in children's (79 vs 46%, P < 0.001). Overnight, ED radiographs of children may at times be solely interpreted by emergency attending physicians in 57% or emergency house staff in 44%. In EDs that allow their house staff to interpret solo overnight, emergency attending physicians are readily available to help with these interpretations less than half the time. A radiologist's second opinion overnight is readily or usually available in 63% of EDs. When any emergency physician interprets a radiograph solo overnight, the interpretation is almost always or often available later to the radiologist during the official interpretation only 40% of the time. Overnight, pediatric cervical spine studies are cleared, at times, solely by emergency attending physicians in 46% and by emergency house staff in 4%. Only 18% of programs have a daily or weekly ED radiograph review with radiologists. An ED atlas of common radiographic variants or a pediatric radiology textbook is available in 69% of EDs.(ABSTRACT TRUNCATED AT 250 WORDS)