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Pediatric Radiographic
Considerations
Chapter 10
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
The Pediatric Patient
• Age: Infancy to 15 years of age
• Requires safety and communication techniques for an
effective outcome
• Requires a sensitive approach toward the parent or
guardian
• Establish a rapport with the parent and child
• Explain the exam to the child when applicable
• Establish eye level contact
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Caring for Children During Radiographic
Procedures
• Infants (Birth – 12 months)
• Toddlers (1-3 years)
• Preschooler (3-5 years)
• School age (6-12 years)
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High Risk Newborn Infant
• NICU
• Hand hygiene
• Appropriate clothing attire including gloves
• Cleanliness of portable
• Consult with infant’s nurse prior to exam
• Never image an infant without assistance
• Provide lead shielding to nurse and self
• Shield the infant
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
The Adolescent or Older Child
• Use effective communication
• Identify the patient
• Explain the procedure
• Educate the patient
• Maintain the patient’s concern for privacy
• Provide after care directions
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Transporting Infants and Children
• Standard Precautions must be followed during
transportation
• ID the patient
• Portable incubator
• Crib
• Gurney
• Wheelchair
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Immobilization and the Anxious Child
• Immobilizers are used when a child is not able stay in
place long enough for a successful diagnostic procedure
• Immobilizers should be used only when no other means
are safe or logical
• Images should be of high quality
• May require the help of the parents and other
technologists
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Immobilizers
• Commercial: Pigg-o-stat, Papoose
• Sheet Immobilizers
• Mummy-Style Sheet Wrap Immobilizer
• Commercial Immobilizers and Other Positioning Aids
– Posi-tot
– Tam-em board
– Infantainer
– Sandbags
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Radiation Protection
• Radiation Protection is a priority for infants and children
because of the radiosensitivity of their rapid and
changing cell growth.
• The radiographer is responsible for using effective
radiation protection measures during pediatric imaging
procedures.
• ALARA should always take place
• Use of appropriate gonadal shielding
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Child Abuse
• Child abuse is any act of omission or commission that
endangers or impairs a child’s physical or emotional
health and development.
• Child abuse includes the following:
– Physical abuse and neglect
– Emotional abuse
– Sexual abuse
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Indicators of Physical Abuse
• History
– The child states the injury was caused by abuse
– Knowledge that a child’s injury is unusual for a
specific age group
– Parent is unable to explain the cause of injury
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Cont.
• Behavior Indicators
– Child is excessively passive, compliant, or fearful
– Child is excessively aggressive or physically violent
– Child or caretaker attempts to hide injuries
– Child makes detailed and age-inappropriate
comments regarding sexual behavior
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Radiographer’s Responsibility
• It will be the radiographer’s ethical and legal obligation to
report child abuse to the person at the institution who
makes the enquiries and the required reports in such
cases.
• Each institution has a protocol that dictates the method
of processing suspected cases of child abuse.
• In most states, the health care worker who reports
suspected child abuse is protected from legal action if the
report proves to be false.
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Administering Medication to the Pediatric
Patient in Radiographic Imaging
• Medicating children can be life threatening and must not
be undertaken by the radiographer. However, if a
registered nurse is unavailable to administer contrast
media to patients under 18 years of age, with proper
education and certification, the radiographer may
administer the contrast media under the Radiologist’s
approval.
• Drug absorption, biotransformation, distribution, use and
elimination are different in infants, children and early
adolescents in comparison to adults.
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Questions Before Administration of
Contrast Media
– Drug or food allergies
– How does the child respond to medicines
– In what form are medicines administered in the
child’s home?
– Will the parent be able to supervise the child after
the exam?
– Any unusual circumstances with medication in which
the physician should be notified?
– Is the parent educated in the action of any possible
reactions to the drug?
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• The assessment and care of the child is usually
performed by a registered nurse who works in diagnostic
imaging.
• Before the child receives a contrast agent or sedating
medication is discharged, he must be assessed by the
nurse or physician and given authorization to leave with
a parent or guardian after the exam.
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Catheterization of Pediatric Patients
• Catheterization may be required for a cystography
procedure, which may include a voiding
cystourethrography.
• Catheterization of pediatric patients is recommended by
registered nurse or physicians who have specialized
education in pediatrics.
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