Pediatric immobilization relates to techniques used to keep children still for medical imaging examinations. Since radiation dose can affect children up to ten times more than adults 1, it is important to keep the radiation dose to a minimum. One method of achieving this is by avoiding repeat imaging due to motion artefact.
Immobilization techniques often vary depending on the department. In general, techniques that are used include 2:
- distraction techniques
- verbal techniques
- physical holding by the parent or radiographer
- Velcro straps
- feed and sleep
The decision to use various techniques are either through departmental protocol or by the judgment of the radiographer. As the patients' age and maturity may affect the type of technique used, studies have shown a potential need for specific immobilization guidelines to assist radiographers 2,3.
Immobilization vs restraint
Immobilization refers to keeping a child still with their consent. Restraint refers to using physical force to hold the child still without their consent 4. Restraining children can increase anxiety and post-traumatic stress for future imaging procedures. In practice, however, children are often unable to give consent and physical force is difficult to quantify. It can then be suggested that verbal and distraction techniques are most ideal when imaging children.
To avoid restraint, some reflections can be made:
- has consent been obtained from the child? (parental consent without a child's consent is still restraint)
- do the benefits of the examination outweigh the risks?
- can other techniques be used to avoid physical force?
- can the child come back to imaging when they are calm?
- 1. Pediatric radiation protection. (2004) European Radiology Supplements. 14 (1): 74. doi:10.1007/s10406-004-0011-7
- 2. Noonan S, Spuur K, Nielsen S. Immobilisation in Australian paediatric medical imaging: A pilot study. (2017) Radiography (London, England : 1995). 23 (2): e34-e40. doi:10.1016/j.radi.2016.12.005 - Pubmed
- 3. Graham P, Hardy M. The immobilisation and restraint of paediatric patients during plain film radiographic examinations. (2004) Radiography. 10 (1): 23-31. doi:10.1016/j.radi.2016.12.005
- 4. Ng JHS, Doyle E. Keeping Children Still in Medical Imaging Examinations- Immobilisation or Restraint: A Literature Review. (2019) Journal of medical imaging and radiation sciences. 50 (1): 179-187. doi:10.1016/j.jmir.2018.09.008 - Pubmed
Related Radiopaedia articles
- imaging in practice
- radiographic positioning and terminology
- systematic radiographic technical evaluation
- pediatric immobilization
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