Five Top Tips for Paediatric Scanning

?Provided by Richard Brindley, Consultant Sonographer, Rheumatology, Davy Unit, Cannock, The Royal Wolverhampton Trust.

  1. Introductions - When you first meet the patient, smile and introduce yourself by getting down to their height level (where possible). Being smiley, relaxed and happy at this point is often very beneficial, as showing them how bad your day is going is not going to help make the patient feel at ease before their scan! You can of course talk to mom and dad after you have made that initial interaction. (Obviously, this applies to younger children, toddlers and those with disabilities, more so than tiny babies.)
  2. Take your time - You cannot rush children into doing what you would like them to do. This may be their first time in the department and the equipment and dark room can be quite daunting and scary. Make the room as inviting as possible, projector/lights or other distraction paraphernalia is often very helpful. Ask the patient if they like stickers or certificates prior to showing them the ones you may have on hand. Yes, it’s bribery but if it works, well, we’ll take the win.
  3. Show them the room and machine - Let them touch the probe and gel to show it does not hurt. If you have a gel warmer this can be of great benefit in paediatrics as they are often told by the parents, “how cold” the gel is! Sometimes you can pretend to scan their favourite teddy or a parent’s hand to show them what it would be like.
  4. Positioning - If the child is particularly against lying on their back, let the parent lie or sit down on the couch first and have the patient lying on the parent’s chest. Obviously not every examination can be done prone, but the majority of a renal ultrasound assessment can be done in this position. And hopefully by the time you have finished scanning in the prone position they will let you scan them from the front, as they realise it is not as bad as they first thought!
  5. No way José - If the patient is still adamant they don’t want a scan and the parents can’t hold them sufficiently still, ask another paediatric ultrasound friendly member of staff to scan the patient, ideally of the opposite sex. I have had this work multiple times.  But if all efforts fail, don’t make it seem like a huge inconvenience.  These things happen, especially if the infant is unwell, tired, hungry or had a previous appointment that went badly. Stay relaxed and let the parents know you will arrange another scan at a more convenient time.