Emergency medicine residencies generally have available agents for pain control and conscious sedation in children, although the agents used vary widely. Appropriate instruction by trained faculty should enhance resident experience with pediatric pain control and sedation.
Objective: To examine the concordance of pediatric radiograph interpretation between emergency medicine residents (EMRs) and radiologists.Methods: A prospective, observational study was performed in a university pediatric ED with an annual census of 60,000 visits. Radiographs ordered by EMRs from December 1993 through October 1994 were initially interpreted solely by the EMR, with subsequent unmasked final review by attending radiology staff. Misinterpreted radiographs were placed into 3 categories. The groupings included overreads, underreads with no change in treatment, and underreads that required a change in treatment.Results: A total of 415 radiographs were interpreted by PGY 1-3 residents. Overall concordance was found for 371 radiographs (89.4%). There were 44 misinterpretations (10.6%), with 24 (5.78%) overreads, 13 (3.13%) underreads, and 7 (1.69%) underreads that required follow-up interventions. Misinterpretations were similar for the different levels of training: The 5 most frequently ordered radiographs were chest (28%), ankle (7%), foot (6%), wrist (5%), and hand (5%). The most frequently misinterpreted radiographs were sinus, foot, shoulder, facial, and hand.
Results
PGYConclusion: 89.4% of all the radiographs interpreted by PGY1-3 residents were read correctly. Only 1.69% of the misinterpreted radiographs led to a change in management. Level of training did not significantly correlate with radiograph misinterpretation rates. have been studied for these groups, we found no prior study that specifically studied the rates of misinterpretation of pediatric radiographs by emergency medicine (EM) residents. Our study objective was to measure the rates of misinterpretation of pediatric radiographs by EM residents, to compare the rates of misinterpretation of various radiographs, and to determine whether a difference in these rates exists with respect to level of training.
Study DesignWe performed a prospective, observational study to measure the rates of misinterpretation of pediatric radiographs when read by EM residents in a pediatric ED using an unmasked radiologist interpretation as the criterion standard.
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