peds

• diapers show up in xrays
• challenges


  anxiety

  attention span is small

  physical limitations
• role of the technologist

  patient safety

  radiation protection

  effective communication

  efficiency

  image quality
• parent involvement


  department protocol (parents can come for anything except occults)

  parent and child wishes

  MD has no law
• advantages of parent involvement

  patient safety

  immobilization

  witness

  patient advocate
• disadvantages of parent involvement

  parents can get them wound up

  exam length increases

  disturbing procedure
• communication with parent


  greet them first if the child cannot communicate

  explain the procedure to them

  remain calm with an even tone when talking

  give the parent 1 job
• communication with the patient

  greet them at eye level

  explain what is going to happen but do not give them a choice

  only give a choice when the outcome is the same

  praise depending on the age
• what are an infants basic needs

  warm

  secure

  fed
• can infants tell a difference between caregivers

  no
• is good for the baby to be crying during an exam

  yes, they will take better breaths
• six months to 2 years old

  fearful of pain, separation from parents, and limitation of freedom of movement

  use immobilization whenever possible

  cannot reason with them

  try again later if they are not cooperating
• 2 to 4 years old


  asks lots of questions (why?)

  communicate at eye level with them

  assure them that the tube wont touch them but it will come close

  "camera"

  try to set up everything before they come into the room

  praise for the action

  validate their feelings

  wait for the tantrum to end before even attempting to get them to work with you

  give alternatives
• 5 years old


  doesnt act their age (scared will appear younger, confident appears older)

  reassure them

  simple explanations
• 6 to 8 years old


  school age

  accommodating

  easy to please

  embarrass easily

  supply 2 gowns

  talk through the procedure

  distract them

  landmarks become easier to find
• adolescent


  preteen

  upset when things interfere with their social or school life

  be clear with explanations

  they will have discussions with you

  want to be treated like an adult

  ask pregnancy depending on the exam
• special needs patients


  talk and treat them like they are cognitively intact

  talk directly to them

  read their expressions

  limit loud sounds and abrupt movements

  dim lights

  could be contracted or have spasms

  take the time to get a good image

  listen to the caregiver

  trust OI patients

  let the patient participate
• efficiency

  room is organized in a manner that is easy to navigate

  set up the room before getting the patient
• organization


  have a plan

  be prepared for something to change
• benefits of restraining devices


  reduces motion which improves image quality

  patient safety

  reduces dose

  "seatbelt"
• Tame-Em board

  newborns to 2.5 years old

  2 sizes

  chest, abdomen, decubs

  board is Plexi glas

  3 straps

  shoulders are at the top of the blue line

  legs are completely straight with the strap just above the knees

  arms are completely straight with the strap directly over the elbow joint
• Pigg-O stat

  on wheels

  bike seat inside

  keeps them upright with arms out of the way

  upright abdomen, chest
• Octagon board


  radiolucent

  chest, abdomen, occults, some extremities, spine

  rotates by 45 degrees

  not mats can be on the table

  3 straps: 1 for elbows, 1 for waist, 1 for knees

  change the arms when doing a skull or cspine
• sandbags


  holding unaffected extremities

  Plexi glas and sandbags

  radiopaque
• weighted blocks


  used to hold cassettes
• Plexiglas


  flatten a hand or other

  hold both sides down or use sandbags
• mummifying


  swaddle with legs still out
• sponges

  obliques

  traumas

  get creative with them
• plain film types


  chest

  abdomen

  hips

  airway series

  foreign body
• surveys


  genetic

  occult trauma

  shunt

  bone age

  scoliosis
• fluoroscopy

  voiding cystourethrogram

  esophagrams

  UGI/SB

  BE

  modified Ba swallow with speech
• doing portables in the NICU

  keep doors closed

  keep them warms

  tray is under the bed
• what to do with leads

  disconnect them
• extracorporeal membrane oxygenation


  ECMO

  we have the only ECMO service in maryland

  acts as the heart and lungs

  cannulas in the neck

  PICU

  lots of elevation

  respiratory therapist is in charge
• Salter Harris 1


  fx through the epiphyseal plate
• Salter Harris 2

  fx through the plate and through the metaphysis
• Salter Harris 3

  fx through the epiphyseal plate and epiphysis
• Salter Harris 4

  fx through the epiphyseal plate, metaphysis, and epiphysis
• Salter Harris 5


  fx is a crushing injury of the epiphyseal plate