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05:30 CET
RC 514 - Successful paediatric imaging
Radiographers Paediatric
Thursday, March 1, 08:30 - 10:00
Room: K
Moderators: V. Syrgiamiotis (Athens/GR), N. Mitreska (Skopje/MK)

A-223
08:30
Chairpersons' introduction: Paediatrics: more than just 'small adults' (part 1)
V. Syrgiamiotis; Athens/GR
Learning Objectives

1. To appreciate strategies for successful imaging of uncooperative children and those with disabilities.
2. To review current guidelines on imaging in suspected non-accidental injury.
3. To demonstrate potential techniques to avoid sedation during paediatric MRI.

Abstract

From paediatricians usually one listens the very common phrase “children are not just small adults”. It is for sure idea for the calculation of drug doses and the assessment of physiological parameters, the definition of child medicine in such defensive, negative and exclusionary terms deals with some inherent dangers and misconceptions as well. In the last decades it is a common phrase used in radiology as well. Both children and adults belong to the human race. Progress in medicine more often can be applied to and be of benefit to all and the transition from childhood to adulthood should be one of continuity rather than migration. Indeed we recognise that children, including the embryo, fetus, infant and all life stages until the completion of adolescence, are often at a different and increased risk from environmental hazards from that of adults. Children often have different, and sometimes unique, exposures to environmental hazards from those of adults. Due to their dynamic developmental physiology children are often subjected to higher exposures to pollutants found in air, water ,food ,and radiation. These exposures may be handled quite differently by an immature set of systems to the way they are dealt with in adults. Children have a longer life expectancy. Therefore, they have longer to manifest a disease with a long latency period, and longer to live with toxic damage. Finally, children are politically powerless; they are defenceless. With no political standing of their own, they must rely on adults to protect them.

A-224
08:33
Chairpersons' introduction: Paediatrics: more than just 'small adults' (part 2)
N. Mitreska; Skopje/MK
Learning Objectives

1. To appreciate strategies for successful imaging of uncooperative children and those with disabilities.
2. To review current guidelines on imaging in suspected non-accidental injury.
3. To demonstrate potential techniques to avoid sedation during paediatric MRI.

Abstract

Paediatric radiology is a unique subspecialty of diagnostic radiology. Radiological findings as well as diagnoses are frequently different in infants and children from adults and knowledge and expertise are important for evaluation of the images. The child and its parents need special care and diagnostic methods must be appropriate selected. Mental development , position and structure of organs , increased susceptibility to radiation are different from adults. Reduction of radiation dose and radiation protection in radiographic examination of children is critical. In paediatric imaging risk- benefit dialogue obtain risk control and maximizing the benefit. Radiographers working with paediatric patients always are facing unique problems , so they must develop competence in knowledge, understanding and skills in paediatric imaging. Exposure is reduced by appropriate selection of study, using non-ionizing examination whenever possible, shielding the gonads and other organs. Radiographer have to capture the attention of the child to keep it still, response to verbal direction , use immobilization devices , understand the role of the family and other modalities for optimization of exposure. For good image quality paediatric protocols should be used to prevent repeat examinations and sedation or general anesthesia is usually require for MRI in children under 7 years of age. Radiologist, paediatric radiologist and radiographers must create team work, partnership and close cooperation.

A-225
08:35
A. Imaging the uncooperative child and children with disabilities
C. Simcock; London/GB
Learning Objectives

1. To learn about behaviours and disabilities that can present a challenge to successful imaging.
2. To understand practical techniques and strategies during projection radiography examinations.
3. To appreciate practical advice for imaging in specialist modality areas such as CT, MRI and US.

Abstract

Paediatric radiography and imaging requires modification of techniques by the radiographer or imaging technologist to ensure that optimal radiographs are produced. Following textbook methods, is simply not always possible in children and for successful outcomes, adaptation of practice is necessary. When faced with imaging children with learning disabilities and challenging behaviours, the task can appear daunting. There is limited literature available to assist the radiographer to meet the needs of children with disabilities. Over 40% of children attending our institution have complex needs and it is important that we learn strategies that both benefit the patient and result in a successful examination across all modalities. Therefore, reasonable adjustments should be made, whilst imaging this cohort of patients which will ensure that the radiographers actions do not have a negative impact on future visits to the imaging department for the patient.

A-226
08:58
B. Suspected non-accidental injury: best practice and advice
B. R. Mussmann; Odense/DK
Learning Objectives

1. To appreciate non-accidental injury imaging as a highly specialised procedure.
2. To understand the image quality requirements in non-accidental injury imaging.
3. To be aware of the legal aspects of performing non-accidental injury imaging.

Abstract

Sub optimal imaging in suspected non-accidental injury (NAI) has major consequences for the child and family. The procedures must work properly each time and the images must be of superior quality to point out the abusers and withdraw the suspicion when no abuse has taken place. Furthermore, performing NAI imaging is a specialist task and special attention should be paid to radiation dose, image quality ,and number of projections. The talk will focus on current guidelines and legal issues in NAI imaging.

A-227
09:21
C. Reducing the need for sedation and anaesthesia in MRI: the role of play therapy and other techniques
J. Gårdling; Lund/SE
Learning Objectives

1. To review the current use of sedation and anaesthesia in paediatric MRI.
2. To understand how play therapy and other techniques can be used to prepare patients for imaging.
3. To become familiar with practical skills and techniques that might reduce sedation rates in paediatric MRI.

Abstract

When a child undergo MRI the unfamiliar environment, meeting new healthcare professionals and the need to keep still might imply anxiety, fear and/or stress. Depending on the child´s age or inability to comply, sedation or general anaesthesia may be required, which implies risks and additional anxiety and discomfort for the children and their parents. Previous research have shown that children needs to have their parents close, play and feel joy, participate in care and have good relation with the healthcare professionals. Furthermore, children needs to know what to expect as this enables them to handle the situation better with increased coping and compliance, and with decreased anxiety. Age-appropriate information and preparation procedures have shown an impact on the child´s anxiety and their ability to comply during different procedures. It have also shown to decrease the need for general anaesthesia. Since children learn and understand situations differently depending on age and cognitive development combining different information and preparation procedures might be considered as an advantage.

09:44
Panel discussion: How to avoid mistakes and to learn from working with paediatrics?
Abstract

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