Patient care

Chapter 4 Patient care





KEY POINTS








PAEDIATRICS


Paediatrics range from the neonate to the young adult and each age presents a different challenge. A child in the hospital environment is faced with strange sights, smells and sounds which can be very frightening. The experience of visiting or staying in hospital may affect subsequent visits, and fears may be carried into adult life. Ensuring a child is as comfortable as possible is therefore essential. Before examining each age group, there are several general points to consider.



GENERAL ISSUES





Dealing with parents and guardians


Parents are often extremely anxious and it can be as much of a challenge caring for them as for the child. Remember that anxiety can result in an overprotective parent who may be more irritable and less patient than usual. When dealing with the parent:







In the past there have been many approaches to keeping children still for radiographic examinations, some of which today are considered inappropriate. Restraining a child should be the last resort. It is preferable to take time to build a rapport with the child in order to gain his trust. If the child is unable to keep still on his own, consider that the presence of a familiar face may be comforting enough to achieve this; for example sitting the child on a parent’s lap.


Lastly, it may seem obvious but never leave a baby or toddler unattended, not even for a second. Even if a baby does not appear to be on the move, it only takes a moment for a him to roll over when your back is turned and this could result in serious injury, especially if he falls from a height.



AGE-SPECIFIC ISSUES


Having considered the general issues, paediatrics have been grouped into the following five age ranges:







Guidance is provided on how to deal with the issues and challenges associated with each age group, although it must be remembered that each child is unique and will develop at his own pace.



The neonate


Babies up to the age of one month are termed neonates (Fig. 4.2). These babies are most commonly encountered on the Special Care Baby Unit (SCBU), although remember that not all neonates requiring imaging are admitted to hospital.






Consider that parents of the neonate:





With regards to the mother, she may have had a traumatic birth and hormone levels are likely to affect her behaviour.


When dealing with the neonate on SCBU:








The older baby or toddler


Although young babies tend not to mind who picks them up, as they become more aware of the world around them they begin to become upset if separated from their parent (Fig. 4.3). It is important, therefore, to ensure a familiar person remains with them throughout their examination.



Although restraint should be considered a last resort, it is vital to remember that babies are unlikely to keep still unless they are sleeping. Holding of the baby by the parent or guardian is preferable to the use of restraining devices such as Bucky bands. In such a scenario, radiation safety is essential and the appropriate guidelines for holding patients should be followed. Older toddlers understand a significant amount and so techniques other than physical restraint may prove effective.





Keeping a baby or toddler as comfortable as possible prior to and during the examination is essential.




Feb 20, 2016 | Posted by in GENERAL RADIOLOGY | Comments Off on Patient care
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