This document discusses proper patient care techniques for radiographers, including safe transfers, patient assistance, radiation protection, body mechanics, moving and positioning patients, and dealing with immobilizers, casts, and traction. Key points covered are the importance of safe body mechanics to prevent back injuries, establishing a stable base of support, keeping the patient's center of gravity close during transfers, and using proper techniques for transfers between beds, wheelchairs, and imaging tables.

1. PATIENT CARE &
SAFETY / PEDIATRIC
Chapter 4 & 7

2. Duties and Responsibilities of the Radiographer
• Safe transfers – from bed to gurney, gurney to table, and
wheelchair to table.
• Patient assistance with bed pans or urinals.
• Patient assistance to restroom.
• Patient assistance with changing into a gown.
• Radiation protection.
• Taking care of yourself – injuries.

3. Patient’s Belongings
• Direct the patient to the correct dressing area for gown changing.
• It is your responsibility to give dressing instructions.
• Lockers for clothing/Dressing room.
• Personal items – jewelry, money, wallets, purses.

4. Body Mechanics
• Constant abuse of the spine from moving and lifting patients is the
leading cause of injury to health care personnel in all health care
institutions.
• Safe body mechanics require good posture- the body is in
alignment.
• The center of gravity is the point at which the mass of any body is
centered. When a person is standing, the center of gravity is at the
center of the pelvis.

5. Body Mechanics
• Proper lifting can reduce injuries & lower back pain
• Low back pain – major cause of disability in adults
• Biomechanics – study of the laws of physics, law of mechanics, as
they apply to living bodies at rest and in motion

6. Cont.
• Biomechanics used to:
• Optimize exercise programs
• Promote greater athletics skills
• Design relatively safe work environments
• Helps researchers discover how people are injured & what can be
done to prevent it

7. Rules for Correct Posture
• Hold chest up and shoulders back.
• Hold head erect with chin in.
• Stand with feet 4-8 inches apart and keep body weight equally
distributed on both feet.
• Keep knees slightly bent.
• Keep the abdomen sucked in
• Buttocks in.

8. Fundamentals
• Fundamentals to good transfer techniques are:
• Base of support
• Center of gravity
• Mobility & stability muscles

9. Base of Support
• Foundation on which a body rests
• when person is standing – space between feet
• Wide – enlarges
• Narrow – unstable & mobile
• When transferring establish a stable base
• Standing with feet apart improves stability

11. Center of Gravity
• Hypothetical point around which all mass appears to be
concentrated – act on the entire body from this point
• Sacral level 2 (S-2)
• Safe moving:
• Hold close to mover’s center of gravity
• Stability – body’s center of gravity over its base of support (always)
• Instability – center of gravity moves beyond the boundaries of base

12. Mobility & Stability Muscles
• Mobility muscles – found in the limbs
• Long white tendons
• Cross two or more joints
Example: biceps / hamstring muscle
• Stability muscles – found in torso
• Large expanses of red muscle
• Provide postural support
Example: latissimus dorsi / rectus abdominis muscle

13. Mobility & Stability Muscles
• White mobility muscles – Lifting
• Red postural muscles – Support
• Lifting should be done by knees
• Bending
• Straightening
• Keep back straight / slight lordosis

14. FIG. 13–4 Mobility muscles include the biceps brachii and the hamstring group. Postural muscles include the rectus abdominis and the erector
spinae muscles.
Elsevier items and derived items © 2007, 2003 by Saunders, an imprint of Elsevier Inc.

15. Rules for Picking Up or Lifting Objects
• Instead of bending at the waist, bend at the knees.
• Use the arm muscles they are effective when pulling, so pull instead
of pushing.
• When moving a patient, balance weight over both feet, stand close
to the patient, flex the gluteal muscles, and bend your knees. Use
arm and leg muscles not the back.
• Protect your spine – Do not twist your body while moving a load,
instead move your foot position.
• Keep floor area clear of objects at all times

16. Principles of Lifting
• Let patient do as much as possible
• Minimizes trauma to patient
• Avoids stress on technologist
• Enhances rapport & mutual respect
• Check the patients chart
• Check for weight bearing status
• Lower extremity fractures
• Unstable joints
• Any weakened or debilitated condition

17. Cont.
• Always tell patient what you are going to do
• Use proper body mechanics
• Keep patients center of gravity close to your center of gravity (best
method)
• Use a transfer belt when able
• Made of webbing or muslin
• Keep back stationary & let legs do work
• Avoid twisting

18. Moving and Transferring Patients
• Several precautions must be taken when moving or transferring a
patient.
• ID the patient first then introduce yourself.
• Request patient information from the registered nurse. Verify the
patients ability to move and comply with the exam.
• Request pt information regarding any restrictions or precautions.
• Move the patient accordingly.

19. Cont.
• Never move a patient without enough assistance to prevent injury
to yourself and the patient.
• Never move a patient without assessing the patient’s ability to
assist.
• When returning a patient back to his/her room:
• Stop at nurses station, return chart, and inform RN or staff that pt has
returned.
• Return patient to the room, help the pt into bed, make them comfortable,
and place bed closest to the floor, with side rails up.
• Give pt the call button in case pt needs assistance.

20. Assessing the Patient’s Mobility
• 1. Deviations from correct body alignment
• 2. Immobility or limitations in range of joint motion
• 3. The ability to walk
• 4. Respiratory, cardiovascular, metabolic, and musculoskeletal
problems

21. Other Assessment Considerations
• The patient’s general condition.
• Range of motion & weight bearing ability.
• Strength and endurance.
• Balance
• Patient understands what is expected during transfer.
• Patient accepting the transfer.
• Medication history.

22. Cont.
• To prevent possible patient injury, always lower the bed to the
lowest position, and secure the rails in the upright position when a
patient is returned to bed.
• Never move a patient without enough assistance to prevent injury
to yourself and/or the patient.

23. Methods of Moving Patients
• Gurney
• Sheet transfer
• Sliding board transfer
• Log roll
• Wheelchair
• Ambulation

24. Cont.
• When moving a patient from the hospital bed to a wheelchair,
always place nonskid slippers on the patient’s feet; this provides
assistance to prevent falls, and secure the seatbelt on the
wheelchair.
• Before allowing a patient to get out of a wheelchair, raise the foot
supports out of the way.

25. Cart Transfers
• AKA
• Stretcher
• Gurney
• Position alongside table on strongest side
• Secure cart
• Sandbags or other devices to block wheels

26. Cart Transfers
• If patient can assist
• Stabilize cart
• Support body part
• If patient cannot assist
• Use a moving device
• Or three people

27. Moving Devices
• Commercially manufactured – all designed to be for cart to table
transfer
• Smooth, thin plastic
• Canvas/plastic, small rollers
• Roll patient on to side away from transfer
• Device placed in mid back
• Roll patient back onto device/
• Move patient
• Roll on side to remove device

29. Moving devices
• Second type – low friction polyester sheet
• Slides patient
• Maxislide, Maxitube, & Maxitransfer produced by Arjo
• Top layer moves with patient
• Protects against abrasions
• Requires less effort & less personnel

30. Lateral Transfer
• Two sheets are needed
• One - directly under patient
• Second – under first to serve as tracks
• If no sheet
• Roll patient to side
• Place double sheeting under
• Roll back on top of sheets
• Both surfaces side by side / as close as possible / same height

31. Lateral Transfer Cont.
• Lock wheels
• Sheets have handles / requires 2 Techs
• Person directing supports patients head/chest
• Other person supports pelvic girdle & legs
• Grab top sheet & slide patient laterally

32. Without Moving Device
• Use a draw sheet
• Roll up draw sheet on both sides
• Person directing - supports head/chest from far side of table –
directs move
• Other person - supports pelvic girdle from cart side – makes
sure cart does not move
• Third person – supports legs from table side
• Patients arms should be crossed
• Patient lifted & pulled to table

34. Cont.
• Can be more difficult
• Potential for strain or injuries
• Not recommended for heavy or seriously injured patients
• Never attempt to kneel or stand on table for transfer

35. Wheelchair Transfers
• 4 types:
• Standby assist
• Assisted standing pivot
• Two person lift
• Hydraulic lift
• Always position the patient so able to transfer toward strong
side.

36. Standby Assist Transfer
• Position the wheelchair at a 45 degree angle to the table.
• Talk to patient:
1. Move the wheelchair footrests out of the way
2. Be sure that the wheelchair is locked
3. Sit on the edge of the wheelchair seat
4. Push down on the arms of the chair to assist in rising

37. Cont.
5. Stand up slowly
6. Reach out & hold onto the table with the hand closest to the
table
7. Turn slowly until you feel the table behind you
8. Hold onto the table with both hands
9. Sit down

38. Assisted Standing Pivot Transfer
• For patients who can not transfer by themselves
• Use transfer belt if possible
• Do the following steps:
1. Move the wheelchair footrests out of the way
2. Be sure that the wheelchair is locked
3. Have the patient sit on edge of the wheelchair
4. Have the patient push down on arm of wheelchair to assist in
rising.

39. Cont.
5. Bend at knees, keep back straight, & grasp belt. Block patients
feet & knees. Place one foot outside patients foot with knee at
medial surface of patients knee.
6. As patient rises to stand, rise also by straightening knees
7. Once standing ask “Are you feeling alright” Let them stand a
minute to gain stability
8. Pivot both of you toward the table until patient is able to feel the
table

40. Cont.
9. Ask patient to support themselves w/ both hands & sit down
10. Help the patient sit . Be sure back remains straight, lower from
knees.
11. Help swing legs around.

42. Two-Person Lift
• For patients who cannot bear weight on lower extremities, must
be lifted onto table
• Must be semi light weight
• Stronger person lifts torso/ other lifts legs
• Verbal planning is required – helps coordination

43. Cont.
• Steps:
1. Lock wheelchair
2. Remove armrests and move footrests
3. Have patient cross arms over chest
4. Stronger person reaches from behind under patients axillae, &
grasps crossed arms
5. Second person squats in front & cradles patients thighs & calves
6. On command patient is lifted clear of wheelchair & placed on
table

45. Hydraulic Lift Technique
• For patients who are too heavy to lift manually
• Functions of a hydraulic lift:
• Have 4 caster wheels – no locks
• A lever controls widening & narrowing base of support
• Two handles for steering
• Manual pump/raising – Release valve/lowering
• Spreader bar for sling attachment

47. Hydraulic Lift Technique Cont.
• Prior arrangements need to be made – so patient is on transfer
sling
• Sling attaches to spreader by hooks & chains
• Longer – sling seat
• Shorter – sling back
• Adjust according to size
• Hook chains from inside out
• Prevents injury

48. Hydraulic Lift Technique Cont.
• Close release valve
• Assure comfort in swing
• Raise the patient until cleared wheelchair
• Open release bar – lower patient
• Guard head
• Remove chains
Leave sling under patient for next move

50. The Use of Immobilizers
• Immobilizers must be ordered by the physician in charge of the
patient’s care and applied in compliance with institutional policy.
• The Joint Commission states that immobilizers should be used only
after less restrictive measures have been attempted and have
proved ineffective in protecting the patient.
• Immobilizers are defined as:
• Any manual method or physical or mechanical device, material, or
equipment attached or adjacent to the person’s body that the person
cannot remove easily that restricts freedom of movement or normal access
to one’s body (Omnibus Reconciliation Act, 1989).

51. Reasons for Applying Immobilizers
• To control movement on an IV or Catheter
• Sedated patients
• Unconsciousness, confusion, delirious patients. This prevents any
possibility of the patient falling or hurting themselves.
• The most effective method to avoid Immobilizers is:
• COMMUNICATION

52. Positioning sponges
• Most common methods of reducing motion
• Come in a variety of shapes & sizes
• Designed to support anatomy while reducing strain from
otherwise holding position
• Increase accuracy of positions

54. Velcro Straps
•Can be effective restraint or positioning device
• Example CXR
• Used to immobilize an area of interest
• Example calcaneus
•Reduces possibility of motion from
uncomfortable position
•Also used as a safety precaution
• Only used for protection – sudden movements will
not result in injury

55. Velcro Restraints
•Designed to attach to table
• 2 brackets that mount to sides of table
• Strap that adjusts to size of patient
• Can be used for compression
• By tightening can enhance
diagnostic information
•Used when patient unable to
stand unassisted – helps assure
patient they will not fall

56. Sandbags
• Useful for positioning & immobilization
• Can be used in varies ways
• By self or with other positioning devices
• Helps reduce voluntary motion
• Are radiopaque (radiation does not pass thru easily)
• Cannot place in area that will obscure information
• Place on gently so not to cause further injury
Example: Lateral C-Spine

57. Positioning the Patient for Diagnostic Imaging
Examinations
• Supine or Dorsal recumbent- on back
• Lateral recumbent – on side
• Prone – face down
• High Fowler – head up 45 to 90
• Semi-Fowler – head up 15 to 30
• Sims – leg over, butt at angle up
• Trendelenburg – head down
• Erect - upright

58. Positioning
• Different positions are needed for most exams
• Once patient is moved to table – can move segmentally into new
positions
• Talk to patient – make sure they are ready for move
• Let patient assist as much as possible
• Always roll toward you
• Provide sponges for comfort

60. Assisting the Patient to Dress and Undress
• Disabled patients (81)
• Elderly patients
• Pathology conditions
• Patient’s with an IV
• Allow enough material to work with by removing the unaffected side first
or by placing the gown on the effected side first
• When changing a disabled patient’s gown, allow enough material to
work with by removing the unaffected side first or by placing the
gown on the affected side first.

61. Skin Care
• Immobilizing a patient in one position for an extended period of
time creates pressure on the skin that bears weight, causing
restriction of capillary blood flow, which can result in tissue
necrosis.
• Moving a patient to or from a diagnostic imaging table too rapidly
or without adequately protecting the patient’s skin may damage
the external skin.
• Persons who are most prone to skin breakdown are:
• Malnourished, elderly, and chronically ill.

62. Cont.
• Moving a patient from the gurney to the x-ray table can cause
scraping or bruising.
• Movement back and forth on a hard table or uneven surface.
• Having your patient lie in wet or soiled sheets for a long period of
time.

63. Cast Care and Traction
• Compression of a cast may produce pressure on the patient’s skin under
the cast, and this, in turn, may lead to the formation of a decubitis ulcer at
the site of cast compression.
• A cast that becomes too tight may cause circulatory impairment or nerve
compression.
• A cast must be supported at the joints when moving it.
• Have positioning tools available: sponges, sand bags, and pillows for
positioning applications.
• Work around the patient. Critical thinking is a major part. Remember, you
need images 90 degrees from each other.

64. Patients in Traction
• NEVER move or remove any of the weights from traction.
• Consult with the patient’s nurse prior to taking x-ray.
• Again, critical thinking comes into play. You and the x-ray tube
must move around the patient.

65. Extremity Trauma
• Traction splints:
• Designed for lower extremities
• Exert force to affected limb
• Applies pressure pelvis & groin
• Radiopaque material – but still can see what is needed with initial x-rays
• Most upper extremity splints radiolucent

66. Assisting the Patient with a Bedpan or Urinal
• Often a patient is unable to safely use the restroom while on a
gurney or x-ray table.
• The radiographer must assist the patient with a bedpan or urinal if
the patient requests it.
• Standard bedpan/Urinal
• Fracture bedpan

67. Urinals
• Males
• Shaped so able to use supine, lying on side, or in Fowlers position
• Used for those unable to walk
• If patient able hand them urinal – collect w/ gloved hands –
dump out – rinse w/ cold water – place in soiled – offer wash
cloth & wash hands

68. Cont.
• If assistance needed:
• 1. put on clean gloves – raise cover slightly
• 2. spread patients legs & place urinal between – place penis into urinal
– hold urinal by handle until finished
• 3. remove, empty it, remove gloves & wash hands

69. Bedpans
• Used for defecation & females for both defecation & urinating
• Two types
• Metal or plastic (most common)
• Fracture pan
• Hand washing important before & after
• If cold run warm water over and dry
• Patient privacy a must - place sheet over them

70. Assisting Patient w/ bed pan
• 1. remove bedpan cover & place at end of table
• 2. place one hand under back – ask to lift hips & place pan –
cover w/ sheet
• 3. sit up if possible
• 4. Do not leave alone for long
• 5. put on clean gloves – patient lays back & raises hips to
remove pan
• 6. remove, cover, & empty

71. Assistance w/ bed pan
• 1. both put on gloves
• 2. assistant stands on opposite side
• 3. Turn patient into lat position
• 4. Place pan against hips – place patient supine and hold pan in
place
• 5. remove and wash hands
Sometimes help needed wiping
• Females from front to back

72. Departmental Safety
• Fire safety (86 – 90)
• Fall Prevention
• Poisoning and Disposal of Hazardous Waste Materials
• Radiation Safety
• ALARA
• Time – Shortest exposure time
• Distance – Increase distance from the source.
• Shielding – shield pt and use collimation.

73. Protection from Radiation
• Strive to produce x-rays with least possible dose to patient
• When patient moves – repeats are necessary – more radiation to
patient
• Voluntary – controlled by patient
• Caused from non communication
• Involuntary – cannot be controlled
• Room temp, medication, disease process, etc…
• Try to perform exam correct the first time to reduce patient dose

74. PEDIATRIC

75. The Pediatric Patient
• Age: Infancy to 15 (18) years of age
• Requires safety and communication techniques for an effective
outcome
• Requires a sensitive approach toward the parent or guardian
• Establish a rapport with the parent and child
• Explain the exam to the child when applicable
• Establish eye level contact

76. Pediatric
• Get down to the child's level
• Establish a positive relationship
• Can present a challenge to interpersonal skills
• Technologist must incorporate:
• Patience - Technical knowledge
• Be understanding - Use effective communication
• And immobilization devices

77. Cont.
• Never separate security object from child’s sight
• Explain exam to parent with the child
• Helps child become familiar with you
• Never leave children alone
• If you can handle children effectively, you can handle anyone

78. Principles in Pediatric Imaging
• “…children are not just small adults…”
• Communication skills
• Immobilization techniques

79. Atmosphere
• Waiting Room
• Age appropriate activities
• Coloring books
• Toys/games
• TV/Movies
• Imaging Room
• Bribery/distraction
• Stickers
• Stuffed animals
• Preparation
• Tube/IR placement
• Lighting
• Accessories

80. Caring for Children During Radiographic
Procedures (7-2)
• Neonate (birth to 28 days)
• Infants (1 – 12 months)
• Toddlers (1-3 years)
• Preschooler (3-6 years)
• School age (6-12 years)
• Adolescence (12-19 years)

81. High Risk Newborn Infant
• NICU – neonates in ICU
• Senses respond to changing enviroment
• Hand hygiene
• Appropriate clothing attire including gloves
• Cleanliness of portable
• Consult with infant’s nurse prior to exam
• Never image an infant without assistance
• Provide lead shielding to nurse and self
• Shield the infant

82. Infants
• 1 month to 1 year
• Not fearful of strangers
• First communications are facial expressions, body movements,
and other non verbal behaviors
• Hold infant like parents – like the familiarity
• Use a soothing voice – It’s okay
• Parents can come in to assist
• Never leave unattended
• 1 year olds can remember feelings of anxiety

83. Toddlers
• 1 to 3 years
• Begin to fear strangers initially
• Understand simple distractions
• Cannot take view point of another
• Use simple words
• Only concerned about now

84. Preschoolers
• 3 to 6 years
• Not able to reason logically or understand cause and effect
• Involved with self image
• They must see and hear to understand
• Must be actively involved to keep attention
• They will not hold still long

85. School-Aged Children
• 6 to 12 years (Age of Industry)
• Begin to think logically and analyze situations
• Can develop deeper understanding
• Fear injury, disease, death and punishment
• Can rationalize with them of why they need the exam

86. Adolescents
• 12 to 19
• Begins for girls before boys
• They focus on body awareness and modesty
• Try to avoid them embarrassment
• Same sex peer eases tension
• Appreciate being treated like an adult

87. The Adolescent or Older Child
• Use effective communication
• Identify the patient
• Explain the procedure
• Educate the patient
• Maintain the patient’s concern for privacy
• Provide after care directions

88. Transporting Infants and Children
• Standard Precautions must be followed during transportation
• ID the patient
• Portable incubator
• Crib
• Gurney
• Wheelchair

89. Immobilization and the Anxious Child
• Immobilizers are used when a child is not able stay in place long
enough for a successful diagnostic procedure
• Immobilizers should be used only when no other means are safe or
logical
• Images should be of high quality
• May require the help of the parents and other technologists

90. Immobilizers
• Commercial: Pigg-o-stat, Papoose
• Sheet Immobilizers
• Mummy-Style Sheet Wrap Immobilizer
• Commercial Immobilizers and Other Positioning Aids
• Posi-tot
• Tam-em board
• Infantainer
• Sandbags

91. Restraining a Child
• It’s difficult for parents to be objective
• When child is confined or strapped down
• Explain what you are doing & why these devices are needed
• Provides minimal discomfort and reduces radiation dose
• Immobilization needed most for neonatal & small children

92. Sheet Restraints
• Most effective, simple, inexpensive & reliable method of
restraining
• Mostly used on really young children
• Under 4 or 5
• Child is wrapped in sheet, securely to prevent movement

93. FIG. 14–16 Sheet restraint (mummification technique) sequence. A, The child is placed in the center of a triangular folded sheet as shown so that
the shoulders are just above the top fold. B, The left corner of the sheet is brought over the left arm and under the body so that approximately 2
feet of the sheet extends beyond the right side of the body. Make sure the child is not lying on the left arm. C, Tuck the 2 feet of sheet over the
right arm and under the body. Again, make sure the child is not lying on the arm. D, Bring the remaining sheet over the body. E, Tuck the sheet
securely under the left side of the body. Remember that this technique restrains most movement but is not satisfactory as a complete
immobilization procedure. Restraint bands are still required, and the child should not be left alone, even for the amount of time needed to make a
radiographic exposure.
Elsevier items and derived items © 2007, 2003 by Saunders, an imprint of Elsevier Inc.

94. Commercial Restraints
• Two forms:
• Upright restraint
• Restraint boards
• Pig-O-Stat – Most common upright
• Radiolucent material
• Large enough for 3 yr old
• Rotates 360 degrees
• Built in lead shields for protection
• Holds securely & safely
• Only drawback – artifacts from sides

95. Commercial Restraints
• Restraint board (infant immobilizer)
• Contour fitting pad, mold, or sponge attached w/ Velcro straps
• Good way to immobilize infants & small children
• Similar to upright restraint device
• Safely secured without being held

96. Commercial Restraints
•Octastop board:
• Modification of Velcro strap board
•Metal frames attached to end
• Child is strapped w/ Velcro around limbs
• Can be rotated 360 degrees
• Drawback – only children up to 1 yr old fit in
device.

97. Noncommercial Restraints
• Plexiglas paddle:
• Immobilizes hands, feet, fingers & toes of young
• Radiolucent
• Apply little pressure to affected area – aides in holding still
• Velcro straps:
• Serves as a reminder not to move on older children & adults
• Tape:
• Used as reminder
• Skin for infants & really young more tender
• Twist to avoid contact with skin
• Can place gauze in between
• Stockinette:
• Stretchable cotton fabric in shape of sleeve
• Used on extremities & secured w/ tape

99. Protection of the Child
• Protection from injury
• Supervision and immobilization of child
• Regular inspection of equipment
• Supervision of inexperienced technologists
• Documentation of incidents
• Radiation Protection
• Proper use of centering, exposure factors, collimation, and filters
• Gonadal and breast shielding
• Considerate patient positioning
• Protection of torso (sternum)
• ALARA!!!
IMAGE GENTLEY – Appropriate exposures
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100. Child Abuse
• Child abuse is any act of omission or commission that endangers or
impairs a child’s physical or emotional health and development.
• Child abuse includes the following:
• The four major types of child abuse are:
• Physical abuse
• Sexual abuse
• Emotional abuse
• Neglect

101. Special Concerns
• Suspected Child Abuse—it is required that a
healthcare professional report suspected
cases of abuse or neglect
• To report abuse, call the National Child
Abuse Hotline: 1-800-4-A-CHILD.

102. Special Concerns
• Signs of child abuse
• Evidence of posterior rib fractures
• Corner fractures and “bucket-handle” fractures of limbs
• Numerous fracture sites
• Varied stages of healing

103. Special Concerns
• Imaging Child Abuse
• Special attention to exposure factors and recorded detail
• Avoidance of the “babygram”
• Individually performed exams of multiple areas

104. Skeletal Survey
• AP skull
• Lateral skull
• AP complete spine
• Lateral complete spine
• AP both Humeri
• AP both Forearms
• PA both Hands & Wrists
• AP Pelvis
• AP both Femora
• AP both Tib/Fib
• AP both Feet
• AP Chest for Ribs
• Lateral Chest for Ribs

105. Radiographer’s Responsibility
• It will be the radiographer’s ethical and legal obligation to report
child abuse to the person at the institution who makes the enquiries
and the required reports in such cases.
• Each institution has a protocol that dictates the method of
processing suspected cases of child abuse.
• In most states, the health care worker who reports suspected child
abuse is protected from legal action if the report proves to be false.

106. Administering Medication to the Pediatric
Patient in Radiographic Imaging
• Medicating children can be life threatening and must not be
undertaken by the radiographer. However, if a registered nurse is
unavailable to administer contrast media to patients under 18 years
of age, with proper education and certification, the radiographer
may administer the contrast media under the Radiologist’s
approval.
• Drug absorption, biotransformation, distribution, use and
elimination are different in infants, children and early adolescents in
comparison to adults.

107. Questions Before Administration of Contrast
Media
• Drug or food allergies
• How does the child respond to medicines
• In what form are medicines administered in the child’s home?
• Will the parent be able to supervise the child after the exam?
• Any unusual circumstances with medication in which the physician should
be notified?
• Is the parent educated in the action of any possible reactions to the drug?

108. • The assessment and care of the child is usually performed by a
registered nurse who works in diagnostic imaging.
• Before the child receives a contrast agent or sedating medication is
discharged, he must be assessed by the nurse or physician and
given authorization to leave with a parent or guardian after the
exam.

109. Catheterization of Pediatric Patients
• Catheterization may be required for a cystography procedure,
which may include a voiding cystourethrography.
• Catheterization of pediatric patients is recommended by registered
nurse or physicians who have specialized education in pediatrics.

110. Examinations Unique to the Pediatric
Patient
• VCUG (voiding cysto-urethragram)
• Assesses bladder function and demonstrates ureteral and
urethral anatomy
• Assesses vesicourethral reflux
• Identify urethral strictures in males