Guideline Knowledge Check – ACCP COVID-19 Guidelines for COVID-19 Imaging

Andrea Eberly, MD, MS, FAAEMEmergency Medicine, Family Medicine, Guideline Knowledge Check, Internal Medicine, Nurse Practitioner, Pediatric Emergency Medicine, Pediatric Medicine, Physician Assistant, Urgent Care

Guideline Knowledge Check - ACCP COVID-19 Guidelines for COVID-19 Imaging

ACCP Guidelines for COVID-19 Imaging

The American College of Chest Physicians Consensus Panel Statement on When and How to Acquire COVID-19 Imaging.

Imaging COVID-19 is an important part of COVID-19 diagnosis and treatment, but is there a recommended method of COVID-19 imaging?

An international panel of physicians experienced in treating adult patients with COVID-19 has developed recommendations for the use of chest imaging (x-ray or computed tomography [CT]). The panel of mostly radiologists and pulmonologists considered clinical scenarios with varying symptom severity, risk for disease progression, disease likelihood, and resources. Panelists rated the appropriateness of imaging for each scenario, held a consensus meeting, and conducted a literature review.

Previously published reports indicated that in settings where patients were encouraged to present early in their course, with mild symptoms, chest x-ray was insensitive. Conversely, in settings with high rates of false-negative testing, CT identified some cases earlier than COVID-19 testing.

However, let's look at the most recent 2020 ACCP consensus panel's recommendations for imaging COVID-19, WHEN and HOW to image COVID-19.

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Today’s Guideline Knowledge Check question comes from the desk of Med-Challenger Emergency Medicine Editor-in-Chief, Andrea Eberly, MD, FAAEM.

The American College of Chest Physicians (ACCP) has published a multinational consensus statement about chest imaging during the COVID-19 (SARS CoV-2) pandemic. What COVID-19 imaging priority is recommended by the ACCP for patients with COVID-19?

A group of medical students reports to a hospital swamped with a large number of COVID-19 patients. They ask about imaging criteria.

What do the new American College of Chest Physicians state about imaging COVID-19 in patients with features of COVID-19 infection?

Answer Options:

T A chest x-ray, but not a CT scan, is recommended in patients with suspected COVID-19 and mild clinical features.

A CT-scan is recommended over a chest x-ray in a patient with a positive COVID-19 test and worsening respiratory status.

 In a resource-constrained environment, imaging is not indicated for the purpose of medical triage of suspected COVID-19 patients.

The guidelines only provide indications for imaging in general without specifying a preferred imaging modality for a given situation (e.g. chest x-ray versus CT scan).

See the Answer:

covid-19 imaging - covid xray bs covid ct

About Guideline Knowledge Checks:

With each update of national clinical practice guidelines, some recommendations change and many remain unchanged. Med-Challenger Guideline Knowledge Checks help you know both what is new and what has stayed the same in the most recent guidelines pertinent to each medical specialty.

About the Author:

Andrea Eberly, MD, FAAEM graduated from the David Geffen Medical School of Los Angeles (UCLA) and completed her residency in Emergency Medicine at the University Medical Center, Tucson, Arizona. After working as an attending physician in Tucson, she followed a recruiting call to the island of Guam, where she served in various roles, including as the director of the emergency department, the EMS Medical Director of Guam, and the Director of the 911 Call System. She has maintained her emergency medicine board certification through three cycles of American Board of Emergency Medicine Board Exams (last in 2014), all three with the help of Med-Challenger.

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