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A paediatric hospital admission should not mandate any routine investigations. A review of the medical literature indicates that routine investigations and/or preoperative tests give a very low yield for unsuspected significant disease in children.
All tests, investigations and/or procedures should be based specifically on the problems identified by a complete medical history and physical examination. They should be ordered at the discretion of the attending physician after a careful review of the diagnostic value of the examinations with respect to the management of the specific illness suspected.
Along with these considerations, the health care provider should also weigh the risk to benefit ratio of the tests, particularly concerning the potential trauma to the child.
However, if investigations are deemed necessary, blood tests should be performed by the micromethod technique whenever possible, and preprocedural sedation, analgesia or local anesthesia should be available as required.
COMMUNITY PAEDIATRICS COMMITTEE
Members: Drs Fabian P Gorodzinsky, London, Ontario; Cecelia Baxter, Edmonton (Alberta), Denis Leduc, Montreal, Quebec (chair and principal author); Paul Munk, Toronto, Ontario (director responsible); Peter G Noonan, Charlottetown, Prince Edward Island; Sandra Woods, Val-d’Or, Quebec
The recommendations in this Clinical Practice Guideline do not indicate an exclusive course of treatment or procedure to be followed. Variations, taking into account individual circumstances, may be appropriate.