An audit on the practice of performing a chest X–Ray in infants with bronchiolitis

Abstract

Introduction: Bronchiolitis is one of the most common medical emergencies in infancy. One in three infants will develop bronchiolitis in the first year of life. 2 - 3% of these require hospitalisation.

Aim: To assess adherence to the National Institute for Health and Care Excellence (NICE) and American Academy of Paediatrics Clinical Practice Guidelines for Bronchiolitis regarding the practice of performing a chest X - ray in infants aged less than 6 months presenting with viral bronchiolitis.

Methodology: Data was collected on infants aged less than 6 months presenting to the Accident and Emergency department (A&E), Mater Dei Hospital, Malta or admitted with bronchiolitis between January - April 2016 and October - February 2016 - 2017. The data was retrieved retrospectively from medical records, processed and compared to the guidelines. Approval was obtained from the Audit Committee and Data Protection Act Committee.

Results: 148 patients were included in the study. 81 (54.7%) had a chest X - ray. 67 (82.7%) of the chest X - rays taken were normal. 28 (34.6%) of the chest X - rays taken were indicated according to the guidelines. Only 9 out of the 81 chest X - rays taken (11.1%) led to a change in management.

Conclusion: Overall percentage compliance to the guidelines was 64.2%. Compliance may be improved by having an easily available local guideline, familiarising paediatric trainees with the guidelines and increasing awareness of the harmful effects of radiation.