Wide Awake and Satisfied: Families find sedation-free imaging for children at Maimonides
Jon Luongo, MS, CCLS
Child Life Specialist
Perioperative Services and Radiology
A relieved parent spoke to us recently after a successful nuclear renal scan for her 5 year old son in our radiology department. She reported she had tried three hospitals before coming to Maimonides and all three explained they would only attempt the study under anesthesia.
An ambulatory network pulmonologist reported positive feedback from families of preschool age children regarding CT scans at Maimonides. The families observed that Maimonides is rare among area hospitals for agreeing to try without sedation (and we are successful!).
A note arrived to our radiology department, from a second grade girl after a successful sedation-free MRI with contrast: “Thank you for everything you did today for me. You were very nice to me. The shot did hurt a little. But I had fun. I never sat that still in my life.”
Such examples of patient and family satisfaction drive our radiology department’s efforts to accomplish sedation-free imaging. And there are other benefits too: sedation-free imaging removes the risks of anesthesia, takes less time, and requires fewer staff members. There are times when sedating children for diagnostic imaging is necessary. But when it comes to successful sedation-free imaging, here are three important ingredients:
1. Assessment of the child’s potential to tolerate the study awake
The process of assessing the child involves physician, child life, technologist, and appointment scheduler, in partnership with the family. It includes factors such as age of the child, developmental challenges, prior healthcare experiences, and length of the study.
2. Preparation for the child and family
Knowing what to expect helps reduce stress, so child life specialists work to prepare children and families using developmentally appropriate language and hands-on materials. Our repertoire includes a recording of the noises an MRI makes, tabletop models of the scanners for medical play, child-friendly explanations of procedures in seven languages, and a “holding still” game children can try at home prior to the day of the study. It helps to know to wear clothes without metal snaps so a child can wear her own clothes into an MRI. It helps to suggest bringing music from home to listen to during a longer study.
3. Family-centered approach to the environment of care
We are working to make our décor more child-friendly and relaxing. It is crucial that the whole care team practices tips and techniques for lowering stress in children and families. We think it helps for staff members to give little prizes for bravery, too.
What’s next on the horizon? Later this year the radiology department will initiate a pilot program to increase the number of sedation-free pediatric out-patient MRIs performed at Maimonides. Using new technology that corrects for small movements a child may make during a scan, in addition to child life preparation and coping support, we hope to set new standards for sedation-free MRI for children. That’s news worth waking up for!