Age Categories
Neonate | Infant | Toddler | Child | Adolescent
Key Differences From Adults
Smaller Size And Organ Proportions | Higher Radiosensitivity | Faster Metabolic Rates | Different Disease Prevalence
Common Pediatric Targets
Head And Neck | Chest And Lungs | Abdomen And Pelvis | Skeletal System | Neonatal Brain And Hips
Minimize Dose Without Compromising Diagnosis
Adjust Exposure Based On Size And Clinical Question | Use Shielding When It Does Not Obscure Anatomy | Prefer Non Ionizing Modalities When Appropriate
Appropriate Use Criteria
Ensure Each Exam Is Clinically Justified | Tailor Protocols To Provide Diagnostic Information With Lowest Reasonable Dose
Child Friendly Approach
Explain Procedure In Age Appropriate Language | Use Distraction Techniques And Parental Presence To Reduce Motion And Anxiety
Technique And Positioning
Use High Speed Detectors And Grids Only When Necessary | Collimate Tightly | Use Appropriate kVp And mAs For Size | Immobilize With Sandbags Or Papoose When Needed
Size Based Protocols
Use Weight Or Diameter Based kVp And mA Settings | Limit Scan Range | Use Iterative Reconstruction And Automated Exposure Control | Consider Noncontrast When Possible
Fast Sequences And Motion Reduction
Use Fast T2 And Single Shot Sequences For Uncooperative Patients | Employ Sedation Or Feed And Wrap Techniques For Infants | Use Pediatric Coils And Small FOV
First Line For Many Indications
Preferred For Appendicitis Neonatal Brain Hips And Abdominal Pain | Use High Frequency Probes For Superficial Structures | Dynamic Scanning And Comparison With Contralateral Side
Low Dose Techniques
Use Pulsed Fluoroscopy Low Frame Rates And Collimation | Prefer Spot Images Over Continuous Fluoro | Use Water Soluble Contrast For GI Perforation Suspicions
Weight Based Radiopharmaceutical Dosing
Follow Pediatric Administered Activity Guidelines | Use SPECT Or PET When Indicated | Minimize Time And Use Shielding For Caregivers When Required
Weight And Age Adjustments
Use Pediatric Protocol Libraries | Reduce kVp For Small Patients | Apply Automatic Exposure Control With Pediatric Curves
Limit To Area Of Interest
Avoid Unnecessary Multiphasic Scans | Use Targeted Imaging And Consider Delayed Or Single Phase When Adequate
Selective Use
Use Gonadal Shielding When It Does Not Obscure Diagnostic Area | Collimate To Reduce Scatter And Dose
Prefer US Or MRI When Appropriate
Consider Ultrasound For Appendicitis And Hydronephrosis | Use MRI For Soft Tissue And Neuroimaging When Feasible
Feed And Wrap Distraction And Parental Presence
Use Feed And Swaddle For Neonates | Employ Distraction Tools Toys And Music For Older Children | Allow Parent To Stay When Safe
Indications And Monitoring
Follow Institutional Sedation Protocols For Agents And Monitoring | Ensure Resuscitation Equipment And Trained Personnel Present | Document Consent And Fasting Status
Topical And Local Measures
Use Topical Anesthetics For IV Access | Provide Age Appropriate Comfort Measures And Post Procedure Pain Guidance
Clear Instructions And Expectations
Provide Written And Verbal Prep Instructions | Explain Procedure Steps And Expected Cooperation Level | Discuss Fasting And Medication Guidance
Safe And Effective Restraint
Use Papoose Boards Sandbags And Tape As Per Policy | Ensure Comfort And Skin Protection | Reassess Frequently During Long Exams
Small Gauge And Secure Lines
Use Appropriate Catheter Size For Power Injection When Needed | Secure Lines To Prevent Dislodgement | Monitor For Extravasation And Document Contrast Dose
Pediatric Equipment And Dosing Charts
Keep Pediatric Sized Airway Equipment And Emergency Drugs Readily Available | Use Broselow Or Weight Based Dosing Tools For Rapid Medication Calculation
Rapid Recognition And Treatment
Train Staff In Pediatric Anaphylaxis Management | Have Age Appropriate Epinephrine Doses And Monitoring Equipment Available
Important For Follow Up And Dose Tracking
Document Patient Weight Or Age Protocol Used Exposure Parameters And Any Sedation Or Complications | Include Comparison With Prior Pediatric Studies When Available
Clear Results And Follow Up Instructions
Provide Plain Language Summaries For Parents | Explain Next Steps And When To Seek Urgent Care | Offer Contact Information For Questions
Feed And Wrap
Technique For Calming Neonates During Imaging By Feeding Swaddling And Gentle Restraint
Papoose
Commercial Immobilization Device Used For Safe Restraint During Pediatric Imaging
Broselow Tape
Color Coded Tape For Rapid Pediatric Drug And Equipment Sizing Based On Length
Weight Based Protocol
Imaging And Medication Parameters Adjusted According To Patient Weight
Iterative Reconstruction
CT Reconstruction Technique That Allows Lower Dose While Maintaining Image Quality