Is ordering a chest x-ray with a first episode of wheezing common practice?

A survey of 552 pediatric emergency medicine (EM) and general EM attending physicians showed that the overwhelming answer to this question was “yes,” according to Contemporary Pediatrics, although the response varied among specialties: only 26% of pediatric residency-trained physicians routinely obtained a chest x-ray, while 54% of EM residency and 68% of other residency-trained physicians did.

“Of the about one-third of attending physicians who obtain a CXR in patients having a first episode of wheezing, 81% indicated that they believe it is the standard of care. Thirteen percent reported that they routinely obtain a CXR only for children younger than a certain age, which ranged from 2 weeks to 12 years (median age of 1 year). Physicians who do not supervise residents in their practice were most likely to obtain a CXR routinely as were those with 5 or fewer years of experience. In addition, practicing in suburban and rural areas and in parts of the country other than the Northeast was associated with higher use of routine CXR.”