Guidelines for Pediatric Applications
CAUTION:
Children are more radiosensitive than adults. Adopting the
Image Gently campaign guidelines and reducing dose for
radiographic procedures while maintaining acceptable clinical
image quality will benefit patients.
Please review the following link and reduce pediatric technique factors
accordingly: http://www.imagegently.org
As a general rule, next recommendations shall be observed in pediatrics:
• X-Ray Generator must have short exposures times.
•
ΑΕ
C must be used carefully, preferably use manual technique setting,
applying lower doses.
• If possible, use high kVp techniques.
Positioning the pediatric patient: Pediatric patients are not as likely as adults
to understand the need to remain still during the procedure. Therefore it
makes sense to provide aids to maintaining stable positioning. It is strongly
recommended the use of immobilizing devices such as bean bags and restraint
systems (foam wedges, adhesive tapes, etc.) to avoid the need of repeating
exposures due to the movement of the pediatric patients. Whenever possible
use techniques based on the lowest exposure times.
Shielding: We recommend you provide extra shielding of radiosensitive
organs or tissues such as eyes, gonads and thyroid glands. Applying a correct
collimation will help to protect the patient against excessive radiation as well.
Please review the following scientific literature regarding pediatric
radiosensitivity: GROSSMAN, Herman. “Radiation Protection in Diagnostic
Radiography of Children”. Pediatric Radiology, Vol. 51, (No. 1): 141--144,
January, 1973:
http://pediatrics.aappublications.org/cgi/reprint/51/1/141.
Technique factors: You should take steps to reduce technique factors to the
lowest possible levels consistent with good image acquisition.
For example if your adult abdomen settings are: 70--85 kVp, 200--400 mA,
15--80 mAs, consider starting at 65--75 kVp, 100--160 mA, 2.5--10 mAs for a
pediatric patient. Whenever possible use high kVp techniques and large SID
(Source Image Distance).
Summary:
• Image only when there is a clear medical benefit.
• Image only the indicated area.
• Use the lowest amount of radiation for adequate imaging based on size of
the child (reducing tube output -- kVp and mAs).
• Try to use always short exposure times, large SID values and immobilizing
devices.
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