Most Proposed Topic :
Healthcare Advances, Research and Innovations (new projects / technology)
Proposed Topic (Second preferred): :
Enhancing Partnership with Patients and Community (Projects initiated to engage patient and improve patient communication)
Authors: (including presenting author): :
Chiu YT(1), Poon MY(1), Kan YL(1), Wong KC(1), Fung KF(1), Ng WK(1)
Affiliation: :
(1) Department of Radiology, Hong Kong Children's Hospital
Introduction: :
MRI scans in young pediatric patients are challenging due to its motion sensitivity and anxiety triggers. However, its high contrast resolution and radiation-free make it pivotal especially in directing an appropriate treatment plan. Children of 3-7 years-old possess great curiosity but lack understanding and patience. Changes in the environment could easily trigger anxiety. Being separated from their parents and exposed to loud noises during scans can further exacerbate their distress, compromising their ability to remain still inside the scanner, resulting in motion artifact which degrades the diagnostic value of the images. General anesthesia (GA) or monitored anesthesia care (MAC) is not uncommon yet drawbacks such as side effects of sedative-hypnotic agents and prolonged visit times need to be taken into consideration.
Objectives: :
To identify key factors of enhancing successful rate of non-sedated supplementary MRI scans in young children, focusing on child-friendly environment, trust-building, effective communication, tailored techniques, and parental support.
Methodology: :
Supplementary MR scans were carried out with the application of the techniques listed below. 1. Shortening scan time: Limiting the number of sequences and utilizing fast and single-shot sequences such as HASTE, TRUEFISP for T2 weighted imaging, and FLASH for T1 weighted imaging. 2. Gaining trust from the patient: Focusing on plain scans without intravenous contrast injection, avoiding pain to relax the patient. Building trust with the patient is crucial and can be facilitated by effective communication and the involvement of a hospital play specialist. 3. Effective communication among stakeholders: Effective communication between radiographers, radiologists, hospital play specialists, parents, and the patient is essential. Scan protocols were discussed with the reporting radiologists to streamline the exam thus minimizing table time prior to the scan. Clear communication with the patient and their parents helped alleviate anxiety and ensures understanding of the procedure. 4. Accompaniment and support: Allowing parents or soft toys to accompany the child during the imaging process can provide comfort and reduce anxiety. Parent-child combo is also useful sometimes. Additionally, seeking support from a hospital play specialist can be highly beneficial. These specialists are trained to provide emotional support and distraction techniques, helping the child stay calm and cooperative during the scan. 5. "Video sedation": Allow patients to watch a video with a MR safe video player during the scan for distraction.
Result & Outcome: :
A 100% successful rate of supplementary MRI scans in young children was achieved with enhanced patient experience, minimized procedure time, and better utilization of MRI facilities.
