Q4 Urgent Caring- Urgent Updates in Pediatrics


Urgent Care Physician and Medical Lead Kings College Hospital Urgent Treatment Centre, London
Abstracts Section Editor, Journal of Urgent Care Medicine  
Convenor Ireland and UK Faculty of the Royal New Zealand College of Urgent Care
Independent Assessor European Reference Network, Andalusian Agency for Healthcare Quality

Risk of hematological malignancies from CT radiation exposure in children, adolescents, and young adults. Nat Med (2023). Bosch de Basea Gomez, M., Thierry-Chef, I., Harbron, R. et al.

What is the risk of radiation exposure to children during investigative procedures such as CT? The EPI-CT study was set up to overcome limitations of previous studies and improve direct estimates of cancer risk from low-dose radiation exposure from CT scanning in childhood and adolescence. It included 948,174 individuals from nine European countries.

The authors found that a typical CT scan today increases the risk of developing lymphoid or myeloid malignancies by about 16%. This means that among 10,000 children who receive one CT examination, about 1–2 radiation-associated hematological malignancies are expected to occur during the 12 years after the examination. The findings highlight the need for raising awareness in the medical community and continued strict application of radiological protection measures in medical settings through justification and optimization of radiological procedures, particularly in pediatric populations.

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Race, Ethnicity, Language, and the Treatment of Low-Risk Febrile Infants JAMA: November 2023
Gutman D, Aronson P, Singh N, et. al.

In fast-paced medical facilities such as UCCs and EDs, clinicians are at risk of implicit bias which can lead to health inequalities. This was a multicentered cross-sectional study of well appearing infants determined to be at low risk of invasive bacterial infections during evaluation for fever. Primary outcomes were the receipt of at least 1 additional intervention: lumbar puncture, empirical antibiotics, or hospitalization. The authors assessed race and ethnicity as a predictor using a 4-level variable (non-Hispanic Black, hereafter referred to as Black; Hispanic; non-Hispanic White, and another race or ethnicity).

The authors found there was no overall association between infant race and ethnicity and the use of at least one additional of the included interventions; however, having a caregiver who used a language other than English for medical care was associated with the use of at least 1 additional intervention contrary to evidence-based recommendations. This study highlights the importance of considering language used for medical care when assessing equity.

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