PEDIATRIC RADIOGRAPHY

Advance preparation Communication- talk and explain in a way children can understand Develops trust Co-operation Reduces chance of repeats Age for comprehension @ 2-3 yrs Advanced preparation helpful ( equipment and technique ready)

Intro+ Child/ Parent prep 1. Introduce yourself 2. Find out some history Explain what you are going to do Discuss immobilization needs / methods

Parents’ Role 3 roles Observer in room- comforter/ supporter Participant- assisting / immobilizing Waiting outside room Parent needs to understand the need for firm immobilization and repeats

Immobilization Pediatrics age range – infant – 12/ 14 Use short exposure times w/ high MA Decrease image blurring to motion Devices include: Tam-em Board- helps w/ extremities Pigg- O- Stat- upright chest/ abdomen Posi- Tot

Other Devices Tape (be careful not to hurt skin) Sheets, towels Sandbags Radiolucient sponges Compression bands Stockinettes Ace bandages

Steps to Mummify Infant Ages 2-3 1. Place folded sheet on table in ½ or 1/3’s 2. Place pt in middle of sheet Place rt arm along side body Pull end of sheet near you across body tightly 3. Place lt arm along side body on top of sheet, bring free sheet over left arm to right side of pt body and around under the body

Steps, continued 4. complete wrapping process by pulling the sheet so pt can not free arms 5. Pull sheet and tape end 6. Tape around knees

Radiation Protection Proper immobilization High MA Short exposure time Limited views Close collimation Lead aprons and half shields

Pre- exam Prep Necessary immobilization devices IR , markers, technique set Projections determined 2 techs determine roles

DR + CR Guidelines for Pediatrics Collimation Accurate Centering Exposure factors Evaluation of exposure index

Alternative Modalities CT Ultrasound MRI ( ADHD, autism) Nuclear Medicine ( certain pathologies unique to newborns and young children)

Pediatric Pathologies: Chest Aspiration Asthma Atelectasis Bronchiectasis Croup Cystic fibrosis Epiglottis Hylaine membrane disease

Pediatric Pathologies: Skeletal Hip Dyspasia Hydrocephalus Osgood –Schlatter disease Osteogenesis Imperfecta Spina Bifida

Differences between children and adults Mental development Chest and abdomen the same circumference in NB Pelvis - mostly cartilage Abdominal organs higher in infants than older children Hard to find ASIS or Iliac Crest in young child, can center 1 inch above umbilicus (bellybutton) Exposure made as baby takes a breath to let out a cry

Flouroscopy Studies Parents usually accompany child Explain equipment and sounds Explain and demo Image Intensifier Shown how they can watch on TV

Child Abuse BCS- Battered Child Syndrome (older term) NAT- non-accidental trauma (current term) It is not the technologist’s responsibility to make the judgement call