Recommendation | Level of Evidence | Strength of Recommendation |
Should do | Assess social risk factors to detect child abuse | C | Moderate |
Offer CPR training resources | C | Moderate |
Educate about BRUEs | C | Moderate |
Use shared decision-making | C | Moderate |
Should NOT do | Chest x-ray | B | Moderate |
VBG or ABG | B | Moderate |
Overnight sleep study | B | Moderate |
Echo | C | Moderate |
Home cardiorespiratory monitoring | B | Moderate |
Neuroimaging (CT, MRI, or ultrasonography) to detect neurologic disorders | C | Moderate |
EEG to detect neurologic disorders | C | Moderate |
Antiepileptic medication | C | Moderate |
WBC count, blood culture, or CSF analysis or culture to detect occult bacterial infection | B | Strong |
Chest x-ray to assess for pulmonary infection | B | Moderate |
Investigations for GER (e.g. upper GI series, pH probe, endoscopy, barium contrast study, nuclear scintigraphy, ultrasound) | C | Moderate |
Prescribe acid suppression therapy | C | Moderate |
Serum Na, K, Cl, BUN, Cr, calcium, or ammonia | C | Weak |
VBG or ABG | C | Moderate |
Urine organic acids, plasma amino acids, or plasma acylcarnitines | C | Moderate |
Laboratory evaluation for anemia | C | Moderate |
May do | Briefly monitor with pulse oximetry and serial observation | D | Weak |
12-lead EKG | C | Weak |
Pertussis testing | B | Weak |
Not needed | Admission solely for cardiorespiratory monitoring | B | Weak |
Neuroimaging (CT, MRI, or ultrasonography) to detect child abuse | C | Weak |
Urinalysis (bag or catheter) | C | Weak |
Respiratory viral testing | C | Weak |
Serum lactic acid or bicarbonate | C | Weak |
Blood glucose | C | Moderate |