PEDIATRICRADIOGRAPHY.pptVIP

PEDIATRIC RADIOGRAPHY The Role of The Radiographer in Dose Reduction for Paediatrics Cynthia Cowling ACR, B.Sc. M.Ed Director of Education ISRRT Development Leader, Radiation Sciences Central Queensland University, Australia Outline Traditional role and techniques Role in CT Dose Reduction Implications for Interventional Dose implications in the move from Analog to digital Some specialized activities The pediatric patient always presents with unique problems for the radiographer Keeping still Use of restraining devices Response to verbal direction Use of shielding Role of the family Other Devices Tape (be careful not to hurt skin) Sheets, towels Sandbags Radiolucient sponges Compression bands Stockinettes Ace bandages Radiation Protection ALARA Proper immobilization Short exposure time Limited views Close collimation Lead aprons and half shields 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 in young child, can center 1 inch above umbilicus (bellybutton) Exposure made as baby takes a breath to let out a cry Essential features Dose should be age and weight specific Dose should be customized to pathology Number of follow ups should be scrutinized Software features should be used if possible Image enhancement Modulation of mAs Working with the radiologist, the radiographer… Starts with standard protocol and then reduces to provide acceptable image Screens all requests, re protocol and suitability of request Attempts to narrow down area of interest Interventional Procedures Increased because of immediate risk benefit for child (not undergoing surgery) However, not much consideration given to long term stochastic effects Collaboration makes a huge difference Example from Hospital for Sick Children, Toronto Canada In Angio CT the TEAM was able to reduce dose from 3 mSev to 0.8 mSev as standard for typica