Dr Vanessa Naguleswaran
Paediatric Registrar, Basildon Hospital, UK
Title: A QI project assessing what proportion of children with neck lumps are having appropriate imaging
Biography
Biography: Dr Vanessa Naguleswaran
Abstract
Background Suspicious neck lumps/lymphadenopathy is a very common reason for referral to paediatrics and for imaging via neck ultrasounds. Out of the paediatric urgent suspected cancer referrals, 39% are due to suspicious lymphadenopathy; however, literature states that isolated lymphadenopathy is a rare cause of malignancy. Aims • Aim to reduce the number of unnecessary neck ultrasound referrals to paediatric radiology and paediatric outpatient clinic for palpable lymph nodes in the neck • To create guidance when investigation or referrals are required for palpable lymph nodes in the paediatric population Method Collated a list of patients over a seven-month period retrospectively, of children that have had ultrasound neck requested by Basildon Radiology department. Then analyse the data to identify how many requests were rejected, cancelled, and authorised. Check how many reports were suggestive of malignancy. Results Out of 247 requests approximately 31% of Neck USS were cancelled/rejected/DNA. Out of a random sample of 50 patients, 0 patients were suspected malignancy. USS was not useful and did not change the management in 96% of the cases (apart from the one patient that had abscess and one patient who had suspected calculi). Recommendation • Present to ED, Paediatric doctors, GPs, Radiologists and Ultra sonographers. • To create a flowchart that can be disseminated to local GPs. • To check after implementation of the flow chart whether there has been a reduction in the number of unnecessary USS requests over a period.