(2019) Journal of medical imaging and radiation sciences. Keeping Children Still in Medical Imaging Examinations- Immobilisation or Restraint: A Literature Review. European Guidelines for AP/PA chest X-rays: routinely satisfiable in a paediatric radiology division?. Kalmar, Emina Talakic, Sabine Weissensteiner, Erich Sorantin. Sebastian Tschauner, Robert Marterer, Michael Gübitz, Peter I. (2014) Journal of Medical Radiation Sciences. Luxembourg: Directorate-General for Research and Innovation (European Commission), 2000.ģ. European guidelines on quality criteria for diagnostic radiographic images. In extreme cases, the parent may stand in front of the patient ensuring they feel safe.ġ. It is important when using this equipment that the children is safely fastened with no risk of falling. Specialized pediatric departments will have 'chairs' appropriate to hold children during examination 5, these chairs often contain multiple Velcro strap points, are counterweighted for stability and have a radiolucent backing such as perspex. It is suggested to try explanations and distraction before automatically assuming the patient requires physical holding 5. However, research regarding the most effective method of immobilization is lacking. The AP erect chest view is often associated with using the parent or a staff member to hold the child’s arms above their head. “you have to breathe in like you are about to blow out a birthday candle!”.In order to streamline workflow, preparing the room beforehand (set up the detector and prepare lead gowns) will be extremely useful in pediatric chest imaging.Įnsuring appropriate inspiration and no motion may also require specialized communication techniques to gain cooperation from the child. Please see your local department protocols for further clarification as they may differ from these recommendations. the head of clavicles to lie at the level between T2 and T4 4Ĭontact lead shielding is no longer recommended for any pediatric examination, multiple radiological societies have released statements supporting the cessation of this practice 6-9 the most comprehensive guidance statement on this matter (86 pages) is a joint report found at this citation 10.due to ossification centers in children, the medial ends of clavicles are difficult to visualize therefore measuring the medial ends of the clavicle to the spinous process is not advised.the clavicles lie on the same horizontal plane and anterior ribs are of equal length 1.ensure 10 posterior ribs in children aged 7 years old and above.ensure 9 posterior ribs in children aged 3-7 years old.ensure 8 visible posterior ribs in children aged 0-3 years old.This is particularly important if the clinical indications query a foreign body as demonstrating the abdomen will also be useful in diagnosis entire lung fields should be visible post-processing collimation is not advisable in pediatric imaging (if it is exposed it should be examined).24 cm x 30 cm or 35 cm x 43 cm depending on the patient’s size.it is advised not to collimate too tightly at the apices as breathing may cause the apices to move superiorly.the level of the 7th thoracic vertebra on or above the level of the nipple.observe breathing by watching the patient’s stomach.have the patient's arms raised above their head.head is straight and chin raised out of the field of view.Ideally, have the child sit on a box or sponge so the legs are below the buttocks 1 full extension) as this creates lordosis. if patient is seated, ensure that the lower limbs are not on the same level as the buttocks (i.e.The choice to perform a PA erect or AP erect chest view will depend on the radiographer’s judgment of the patient’s cooperative and understanding ability. However, the AP view will result in an increased radiation dose to radiosensitive organs and magnify the heart and mediastinum 1. 2.The AP erect view is often chosen over the PA erect view for younger children as this view allows for observing the child’s breathing and decreased patient stress (due to the child being able to observe what is happening in the room).inform the patient that the image will be taken on suspended expiration.the detector is placed portrait, running parallel to the long axis of the cervical spine on the patients left the side.the patient is supine or erect, depending on trauma or follow up.It also helps to demonstrate any adjacent soft tissue structure, osteoarthritis and spondylosis. This projection helps to visualize pathology involving the entire cervical spine orthogonal to the AP view and is often performed in the trauma setting.
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