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1. Introduction

1.1 Children attending the imaging department are an integral feature of day to day practice and  radiographers in the course of their daily work will be required to undertake procedures on children and young people from birth to adulthood in a variety of situations both as in and out patients.

1.2 In the UK, in a typical year, it has been estimated that up to half of infants under the age of 12 months and one quarter of older children will attend an Accident and Emergency Department. In any year, one in eleven children will be referred to a hospital out patients department and one in fifteen will be admitted to hospital. One in ten babies born each year will require admission to a neonatal unit  of whom about 2% will require intensive care (DoH 2003). It is therefore highly likely that a radiographer, wherever they work, will be required to image a range of children of all ages.

1.3 It is important that children and young people of whatever age are not treated as ‘smaller’ adults either through the communication strategies used or in terms of radiation doses. Children are three to five times more sensitive to radiation than adults. In this group of patients, cumulative radiation exposure could have adverse effects in the long term, therefore radiation doses must be kept at the minimum required for adequate diagnosis. In the USA, the ‘Image Gently’ campaign, which is an alliance of 13 medical societies focuses on an effort to ensure that medical protocols for imaging children, particularly using Computed Tomography, keep pace with  advances in technology. The campaign concludes that the techniques used in paediatric imaging are not necessarily always tailored to children's smaller bodies, resulting in radiation exposures that are greater than needed.

1.4 The Kennedy report (1991) following the deaths of children undergoing heart surgery at the Bristol Royal Infirmary in the 1980s found that staff skilled in treating adults had no specific additional training in treating children and that facilities provided bore no relation to the differing needs of small children, older children or adolescents.

1.5 In the UK, children and young people from ethnic minority backgrounds make up approximately 20% of the total population aged less than 19 years; this is a higher proportion than older (ethnic minority) age groups which is approximately 6 %. It is important therefore that the design and delivery of services for children and young people reflects this cultural diversity.

1.6 Standards in paediatric imaging are necessary because children and young people make up such a high percentage of patients in imaging that they should not be seen as a specialist requirement. However, it is recommended that a specialist radiographer with a paediatric role should be located in all general departments to co-ordinate the provision of children’s facilities, protocols and guidelines and cascade staff update training on imaging children. A specialist radiographer who has completed post qualification education relevant to paediatrics should also undertake or supervise examinations which are complex and which may involve forensic and legal elements.

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