Preparation and Support is Key to Safe Imaging with Pediatric Patients

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Alexander Towbin, MD, Neil D. Johnson Chair of Radiology Informatics, Cincinnati Children’s Hospital (left), and Catherine Leopard, Child Life Specialist, Cincinnati Children’s Hospital (right)

Patient comfort has always been an important component of the medical imaging process. However, when imaging pediatric patients, comfort becomes vital. There are many components of medical imaging that can intimidate children, or be downright scary for them. Like many other pediatric radiology departments, the Radiology Department at Cincinnati Children’s Hospital employs child life specialists to help support our patients and their families before, during, and after their radiology appointment.

Child life specialists are trained professionals who work with our patients and their families to assess and understand each individual’s specific psychosocial needs. They then work collaboratively with the radiologist and technologist to ensure that the procedure goes smoothly and that high-quality, diagnostic images are produced.

Successful pediatric imaging is dependent on proper preparation before the procedure.

There are many things that can be done to help pediatric patients and families prepare for a radiology procedure. In our department, child life specialists often first contact a patient’s family by phone before the appointment to discuss developmental information, stressors related specifically to the radiology examination or other important information the family believes might impact their child’s ability to cope positively during the procedure. Obtaining this information ahead of time allows us to adequately prepare for our patients so that we can provide them the best experience possible.

We believe that it is important to provide our patients’ and their family information about the radiology procedure in a manner that they can understand. In order to do this, child life specialists first assess a child’s developmental level as well as his or her current mood and anxiety level. Once this assessment is made, child life specialists use appropriate pictures, videos, medical dolls, sample medical equipment and/or models to help prepare the patient for what he or she will see, hear, feel and experience during the radiology examination.

Pediatric imaging always requires the utmost care and preparation to ensure the image is properly captured and the patient remains comfortable.

The education process can begin either before the examination is scheduled or after a patient has arrived. For example, children who are scheduled to have a MRI at Cincinnati Children’s can come to the Radiology Department beforehand to tour and “practice” the scan. They can see the MRI room, lay in the scanner, and hear the sounds the MRI scanner makes. All of this preparation helps to answer questions, build the patient’s confidence, and ultimately leads to the successful completion of the MRI.

We have found that when children are appropriately prepared for an examination they are able to more successfully cope with the experience. While it is important to produce high quality images in order to accurately diagnose disorders, we believe that it is just as important to perform the examination in a way that is supportive of the patient and family. These two goals can only occur when members of the radiology department work together as a team. We use these principles every day to make the imaging experience as stress-free as possible for children and their parents.

When playtime leads to a lesson: a case study.

An example that illustrates this point occurred recently in fluoroscopy. A 4-year-old boy arrived in our department for an upper GI examination. After assessing the boy, the child life specialist discovered that the large and confining space of the fluoroscopy camera was scary for him. In order to help calm the boy’s fears, the child life specialist played with him, using the camera to play hide-and-seek. This helped the child to become more familiar with the equipment and feel less overwhelmed. The child life specialist then spoke with the technologist and radiologist discussing the patients fears and offering suggestions (such as slowly moving the tower and keeping it a little higher than normal) to lessen his stress and anxiety.

During the study, the child life specialist engaged the patient in play and directed that play in specific ways to help the patient achieve the necessary positioning and cooperation for the imaging. This attention to the boy’s fears helped him to easily get through the examination. This kind of supportive experience has a lasting effect on our patients and allows them to gain confidence as they undergo repeat examinations.

Collaboration between child life specialists and parents can keep children at ease.

We encourage parents to be involved in their child’s care throughout the Radiology appointment. Parents can help prepare for an examination and soothe their child during the procedure. Parents can use the Cincinnati Children’s Radiology website to learn accurate information about their procedures. They can also view pictures of CT and MRI equipment with kid friendly explanations so that children can become familiar with the process before their appointment. As part of the preparation process, a parent can demonstrate what the child will need to do. Children look to their parents for clues on how to handle new experiences, so when the parent practices first, it helps the child to think, “If Mom or Dad did it, so can I.”

When a child is scared, we know that a parent can make him or her feel better. We encourage parents to stay close to their child during most examinations and encourage them to hold hands, sing, or play throughout the procedure. Literature supports that when parents are given good information on what to expect during the procedure and are given an active role to play, their stress is lessened, which ultimately lessens the stress of their child.

Child life specialists have a central role in the Radiology Department at Cincinnati Children’s Hospital helping us to better care for our patients. We see their impact every day in the smiles of children and their parents.

Read the related blogs on Pediatric Radiography Techniques by a seasoned #radtech; and  Shriners Hospital for Children Tips for Imaging Pediatric Patients.