PEDIATRIC RADIOGRAPHY

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PEDIATRIC RADIOGRAPHY

• Bontrager Chapter 20

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• Communication
• Age for comprehension _at_ 2-3 yrs
• Advanced preparation helpful
• Child has toy if possible
• Work method

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Intro Child/ Parent prep

• 1. Introduce yourself
• 2. Get history
• 3. Explain what you are going to do
• Discuss immobilization needs / methods

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Parents Role

• 3 roles
• Observer in room
• Participant
• Waiting outside
• Parent needs to understand the need for firm
  immobilization
• Repeats

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Immobilization

• Pediatrics age range infant 12/ 14
• Use short exposure times w/ high MA
• Reduce motion
• Devices include
• Tam-em Board- helps w/ extremities
• Pigg- O- Stat- upright chest/ abdomen(2yrs)
• Posi- Tot

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Other Devices

• Tape (be careful not to hurt skin)
• Sheets, towels
• Sandbags
• Radiolucient sponges

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Steps to Mummify Infant

• Ages 2-3
• 1. Place folded sheet on table in ½ or 1/3s
• 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

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

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Radiation Protection

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

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Pre- exam Prep

• Necessary immobilization devices
• IR , markers, technique set
• Projections determined
• 2 techs determine roles

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DR CR Guidelines for Pediatrics

• Collimation
• Accurate Centering
• Exposure factors
• Evaluation of exposure index

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Pediatric Pathologies

• CHEST
• Aspiration
• Asthma
• Atelectasis
• Bronchiectasis
• Croup
• Cystic fibrosis
• Epiglottis
• Hylaine membrane disease

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• SKELETAL
• Hip Dyspasia
• Hydrocephalus
• Osgood Schlatter disease
• Osteogenesis Imperfecta
• Spina Bifida

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Differences 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- center 1 inch
  above umbilicus
• Exposure made as baby takes a breath to let out a
  cry
• 5 yr olds can hold breath

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Fluoroscopy Studies

• Parents
• Explain equipment
• Image intensifier
• Show TV monitor

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Child Abuse

• BCS- Battered Child Syndrome (older term)
• NAT- non-accidental trauma (current term)
• Who makes the judgement call?

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