5a . Pediatrics - Workflow SSH Flashcards
what is the difference in paediatric workflow that need to be kept in mind - 3 things
prepare everything before the patient arrives in the room as window for the patient to be cooperative is small
body before bit positioning and position the parent
who can restrain patients in paeds
over 18yo and not pregant
what are 5 equipment that can be used as restraints
linen sandbags lead gowns perspex lead gowns sponges
how do you restrain babies with cloth nappies
fold into a triangle and wrap each side over tummy and under bum
babys weight keeps it in place
how can you figure out what exposures to use for paeds
think about lowest exposure avail 50 at 1.6 and think about what youd give for adult equivalent anatomy
think about what adult body part is the same thickness and density
what is the magic exposure for paeds
60 at 2
what is the exposure for baby supine
60 at 2
what is the effect of SID on exposure comparing the supine and sitting up views
what are the tech factors for each positioning
photons dont have very far to travel in supine views but more distance to travel for sitting up views
sitting = 70 at 2 supine = 60 at 2
what is the average abdo mAs correspond to
the age of the child
do you use grids for lateral chest
yes for bucky lateral chest
what is the difference between fractures and growth plate lines
growth plate lines are smoother and less jagged/fragmented, almost more sclerotic than # lines
what is DDH
developmental dysplaysia of the hip
what is the characteristic of DDH
misshapen acetabulum
what view does a DDH need
AP pelvis only
why dont you need a lateral for DDH
No lateral needed as the acetabulum is the issue, not the femur so lateral femur doesn’t give more info about acetabulum
what views can be done for DDH in hip spiker
AP frog leg laterals
what are the 5 DDH signs
breech birth uneven creases family hx clicky hips abnormal crawl/walk
what age group do you do DDH views for and why not other ages
> 4months
pelvis not fully developed to see DDH until baby is 4months old
what line is used to see if there is DDH
shentons line = between inf aspect of pubic ramus and medial aspect of the fem neck
acetabulum index line = normal if closer to horizontal
what is SUFE pathology
slipped upper femoral epiphysis
what is the age range for SUFEs
10-15yo bigger active kids
what views are needed for SUFE
AP pelvis and frog leg lateral
what are buckle fractures
cortex gets compressed into little bulge instead of breaking cortex
what are greenstick fractures
in only one side of the cortex and not the other
what is a toddlers # and what view is needed
spiral # of tibia
needs oblique tib fib view
what age range of paeds can do chest xrays supine
<4months
what age range of paeds can do chest xrays sitting
4months-5yrs
what age range of paeds can do chest xrays bucky
5+ years
how do you correct for the lordotic view of the baby chest AP view
put 15* sponge under chest with thick bit under shoulders or angle 15r* towards feet to match sternum
what is the pro and con of using sponge or angle method to correct baby AP chest lordotic angle
Sponge allows chin to get out of way but have to get sponge out for lateral
Get a bit of chin artifact with supine baby chest angled
what needs to be done to the babys arms for AP chest view
clamp elbows to ears
where do you center for baby AP chest view and where is the collimation
midline of nipples
light down to north of belly button to ensure crests are not included
why do you do lateral chests views for paeds first
calms patient as they can see parent while xraying
what are 4 factors to consider when imaging neonates
temperature
low immunity
handling
incubators
how do you tell if there is an inhaled foreign body and what views do you take
inspiration and expiration AP/PA chest
mediastinum may be pushed to one side and only one lung works and changes in volume in inspiration/expiration
how do you see if baby is breathing in or out
watch abdomen or listen to crying sounds
silent = breathing in
what are soft tissue necks taken for
query enlarged adenoids
what is the collimation for soft tissue neck view
nasal cavity to C7
what is pelvis baby positioning
straighten legs and held together and turned in
what is the collimation for baby pelvis
top of light in line with belly button and bottom of light to bottom of genitals
what is used in theater to fix fractures and stuff
k wires
what are the differences in adult and paeds theatre in terms of dose, grid and FOV
dose can be reduced
cone in a little more
need mag settings to see little fingers and toes etc
what is MCU
micturating cystourethrogram
what is MCU used to query
?urinary reflux
how is contrast used in MCU
contrast into bladder via catheter
what is a tactic used to get children to eat barium
keep nil by mouth before so theyre hungry for food and want to eat
what are views needed for NAIs
initial skeletal survey and CT head
when are secondary surveys used for NAI skeletal surveys and why
secondary 2wks later to see healing fractures
what are special considerations for NAI skeletal survey xrays
images may go to court so use proper markers and check no artefacts
check image with radiologist before sending
