How do you feel about doing supine or upright chest xrays on children (2 yrs and under)?
This is a compendium of several responses to the question about chest Xrays on children under the age of two. Many Radiologic Technologists answered the question listed in the title.
Short answers of less than five words were omitted. We hope this helps give you some ideas on how to handle this at your facility.
If no cassette holder, I have put a cassette on the back of a chair, put child AP and had parent hold arms up if they cooperate.
I have also (when supine didn’t work either, lol) put them at the end of the table, so they are PA, cassette sitting on their legs, their parent in front holding their upper arms to the side of the cassette. Sometimes that works because the child can see the parent and the parent can distract.
If that doesn’t work, back to their ordering provider they go. The more you try to hold them, the more chance of an injury happening to everyone involved.
Rad Tech JB
I do all of them upright unless they are really little. If they are able to sit up I use the cassette holder and have the parents hold. I can usually get PAs on just about all of them. If they are standing I do them on the wall. Really comes down to how well they are being held.
Rad Tech BK
I seat them at the end of the table. Have their parents hold their arms up and put a cassette in between the two of them. Then let him cry and catch him on inspiration
Rad Tech KL
If the child can hold head upright on its own. Upright cxr
Rad Tech CW
Have them sit up at end of table, put cassette in front of them hold their arms around and against the cassette. With tube at other end of table PA 85@5
Rad Tech Hk
if I’m solo they’re supine, if I have help they’re upright.
Rad Tech AA
If alone swaddle supine position, but if parent is there have them hold the pt extremities. My clinic doesn’t have a pig-O-stat.
Rad Tech MM
Sometimes it is honestly easier. I find situationally if you need to do supine chest on kids when they refuse to cooperate and sit up and hold still (if you dont have piggostat available or enough holding help) that they’ll cry but once you roll them on their side they lose their sh**. Just need to turn your tube for xtable and have someone hold arms up and shoot. Benefits to each way situationally. Pros and cons
Rad Tech AH
At the children’s hospital I work at, all are done upright unless in nicu. I actually work at the urgent care for the hospital and have done uprights on a week old baby. It can be done. Even without a piggostat cuz we don’t have those. I used to work alone and would just have a parent hold. Sometimes get a nurse to help hold.
Rad Tech JS
I dont have a ?-o-stat either. I do upright APs often but when it comes to the lateral and the parent holding them, it gets more testy. I have had to lie a few kids down.
Rad Tech TM
We do have a pig-o-stat so I do prefer to use it when possible. If child is too big for it, I rather hold the arms due to increase chance for rotation if parents hold, so parents hold the hips/legs down. The protocol for 6mos and under is supine/XTL
Rad Tech YC
We use a tame em board
Rad Tech VM
We fortunately have one of these. But I work at a pediatric center so we have no excuse. All are upright, I think my youngest was 8 days old. Good up to 2-3 years, after that I sit them on a box against the Bucky . Parents help w holding the arms up.
Rad Tech SHS
I do all I can to get AP or PA upright. I usually can with the parents holding them. The laterals get challenging with it though. Lastly, the provider orders them and pushes to do them lying down because a lot of exams were done that way at her old job.
Rad Tech TM
If they can’t hold their head up they get supine. All others that will fit in pigg o stat get upright. If they’re too big for the pigg o stat they stand.
Rad Tech JC
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