Pediatric Care: Upping the X-ray Comfort Quotient During COVID-19 and Beyond

Rob Fabrizio, Director of Strategic Marketing, Digital Radiography and Women’s Health, FUJIFILM Medical Systems U.S.A., Inc.

Taking steps to improve pediatric imaging, comforting patients and securing high-quality scans, is critical now and for the post-pandemic era.

Children have long been frightened by hospital stays. Daunting needles, sterile rooms, and scary machines can make hospitalization a frightening experience for young patients. Now, we can add one more major fear factor to the list: separation anxiety.

It’s no secret that pediatric cases of COVID-19 are increasing across the nation. Due to the contagious nature of the disease, a COVID-19 hospitalization stay can be a very lonely journey.

As of December 24, 2020, 2 million children tested positive for COVID-19 since the onset of the pandemic, according to the American Academy of Pediatrics. Today, children represent 12.4 percent of all cases in states reporting cases by age as compared to just 2 percent of all COVID-19 cases in April.

Scientists believe that a new strain of COVID-19 recently detected in the United Kingdom may spread more easily in children than previous forms of the virus.Data collected over a six-week period found that the proportion of cases of the variant in those under 15 was “statistically significantly higher” than the non-variant virus.

Fortunately, most children with COVID-19 do not require hospitalization.While many will recover at home, kids who come down with more serious symptoms and/or complications and do end up hospitalized also end up isolated from their parents. Separation anxiety compounds an already frightening situation, which can impede both treatment and healing.

COVID-19 should be a powerful motivating factor for hospitals to “up the comfort quotient” for all pediatric patients. The lessons learned from this tragic pandemic should be applied in the time of COVID and beyond. Simply put, children suffering from any malady are likely to have better experiences and outcomes when they are at ease—as free of fear as possible. This article will explore the many steps hospitals can take to improve pediatric patient comfort.

Diminished comfort-giving role for parents during pandemic

COVID-19 is turning back the clock on hospital visitation practices. According to an article in The New York Times, unlimited parental visiting hours are relatively new in American hospitals.From the early 1900s to the late 1950s, most U.S. hospitals had strict rules separating children from their parents and limiting parental visits to just a few hours each week.

It wasn’t until the 1960s that advances in hospital architecture dramatically altered accommodations for family members. During this time, parents began to play a significant supporting role. They provided their children with the non-medical, but very necessary, comfort they needed to undergo tests and treatment and, ultimately, recover.

In a 2007 study published in Journal of Pediatric Psychology, all 135 U.S. and Canadian hospitals that completed the survey reported that their general pediatric unit “allowed parents to sleep at the bedside overnight.”Moreover, 99 percent of those hospitals (133) reported parental involvement in their child’s care at night, with 39 percent stating that this was an expectation.

However, with COVID-19 the pendulum has swung back to days of old.Now is the first time in many decades that so many pediatric patients must deal with being alone in the hospital.

Isolated children suffering from COVID-19 or other contagious diseases are likely more frightened than ever—and that, in turn, can impede treatment and healing. Moreover, even children with other ailments may find themselves cut off from parents due to COVID-19 precautions especially if it continues to surge and hospital visitation rules become as restricted as they were in the spring of 2020.

Related Content: Building Trust in Pediatric Imaging

Now, more than ever, healthcare providers need every edge they can get when it comes to easing anxiety, pain, and trauma for the nation’s littlest patients.

Why comfort matters: A little psychology goes a long way

Children are easily frightened by the unfamiliar and are taught not to trust strangers. So, it is easy to understand how a stay in a hospital—and possible separation from parent(s)—can ignite terror in many young patients.

The problem for providers is not simply an unhappy child, but rather that anxiety and fear are a clinician’s worst enemy because these emotions hinder examinations, diagnosis and treatment. By reducing apprehensive emotions in young patients, clinicians can save time, obtain more accurate assessments, and are less likely to require a retake or “miss” something.

Adolescents, toddlers, and infants already have a hard time keeping still without the added dynamic of pain and fear.With relaxed pediatric patients—versus terrified, nervous ones—physicians can get to the root of the problem sooner. That translates into better more efficient exams, faster treatment, and improved patient experiences.

A little bit of psychology can go a long way. Comforting details and practices can make a world of difference in quelling anxieties. This includes everything from your facility setting and your staff, to your technology.

High tech form meets function for safer, more comfortable care

Technology saves lives, but for children it can be seen as scary stuff. Children in pain undergoing even routine tests can be filled with increased worry and fear, making them anxious and impeding care.To put children at ease, an X-ray can be introduced as something fascinating and a pain-free exam to undergo. Digital radiography (DR) is a painless and powerful tool in diagnosing a wide array of symptoms.

It’s imperative to utilize DR detectors that deliver high-quality images, with as low radiation dose as possible—to keep the smallest, most sensitive patients safe. Young patients are more susceptible to the negative effects of radiation dose and low dose and low penetration typically impede image quality. To this end, Fujifilm’s detectors all incorporate innovative and proprietary core technologies, designed to maximize sensitivity which in turn improves dose efficiency at ultra low doses and the resulting image quality compared to conventional designs. What’s more, these detectors take safety a step further incorporating an anti-bacterial coating to provide an added measure of infection controls against hospital-acquired infections. This was always important, but even more so during this era of COVID-19.

While safety always comes first, comfort is key. For instance, it's not news that children have a hard time holding still.

One example of technology that helps speed exams, minimize discomfort and image gently is Fujifilm’s FDR D-EVO GL. Long length views are commonly utilized for trauma and on adolescents for scoliosis treatment that spans over the course of several years. Naturally minimizing dose and preventing retakes are extremely critical to these exams.The GL is the world’s first single-exposure, long-length DR detector. It reduces discomfort for a better patient experience by speeding image acquisition with just one exposure. One-exposure minimizes the need for kids’ to hold still compared to traditional multi-exposure DR methods. So kids in pain and kids that are just kids don’t have to hold still as long to get a great X-ray instantly. Instantaneous acquisition of a full length view minimizes dose and prevents repeat exams caused by patient movement and, of course, the additional associated radiation dose.

Portable and mobile equipment are also important to pediatric care departments for several reasons. It’s speedy, efficient, and mobile equipment helps keep kids comfortable. With mobile DR units, images are captured and displayed in seconds at the patient’s bedside—so children don't need to be transported to the radiology department. Kids can be easily frightened when they are moved from their beds and don't know where that gurney is going!

Children and adults are also commonly fearful of cold-looking X-ray exam rooms and machines – but there are ways to make mobile X-ray technology less intimidating and even fun.

Mobile DR units like Fujifilm’s FDR Go Plus feature choices of kid-friendly graphic decals that ease young patients’ (and their parents) fears prior to the exam by making the equipment look more animated and less intimidating and clinical. This makes the tech’s job easier and improves the chances of getting a speedy, accurate exam the first time.

Moving away from bigger, bulkier units has put children at ease according to radiology staff at the Children’s Hospital at OU Medical Center in Oklahoma City. They say previous portables could put panic on kids’ faces as soon as they were wheeled into the room. But that has changed, thanks to kid-friendly designs and bright illustration vinyl wraps that are wrapped around the FDR Go units they presently utilize.

Portability can also help keep infants comfortable and safe in the NICU. These helpless tiny infants are wired up with countless wires and tubes—the slightest movement can cause them to stay awake and cry for hours. To help keep them safe and secure in their isolette, Fujifilm’s special small 24x30cm DR detector is designed to fit perfectly in the cassette tray under the the bed, so the infant doesn’t have to be picked up, placed and held directly on a cold detector, as is the case with larger detectors. Exams are faster, safer and the baby stays peacefully secure in its germ-free environment.

Human touch: The power of warm and fuzzy

While comfortable testing is the secret sauce to effective pediatric care, there are several other steps hospitals can take to enhance the comfort quotient.

For starters, a cheerful setting establishes a positive mood and helps set the tone for a successful pediatric hospital stay. Calming colors, bright murals, playful images and plush toys put children at ease. Experts that create hospital spaces, say research shows kids prefer warm, inviting colors for corridors and rooms.

Music—the universal soother—can make a world of difference, too. Studies show that music can ease children’s anxiety during difficult procedures. A recent study published in Healio found that kids get through endoscopy procedures with less strife when music is played.

Communication helps alleviate fears, as well. Too often clinicians talk to parents and leave children in the dark. But fear is largely about the unknown.It’s important for physicians and X-ray techs to include kids in friendly conversations, and make the exams and equipment interesting to help put patients at ease. Conquering fears begins with young patients understanding what procedures they will undergo.

Finally, your staff can be your greatest asset in keeping our young patients happy and comfortable. A caring smile and a gentle touch can go a long way with little ones.

Happier children, healthier children

COVID-19 is just our latest reminder of how challenging hospitalization can be on the young. Every year more than 3 million children are hospitalized in the United States. Whether it’s for a surgical procedure or a sudden illness, an accident or a traumatic event, a hospital stay can mean emotional upheaval for a young patient.

Upping the comfort quotient with everything from a cheerful space to well thought out technology can help ease patient anxiety and make clinicians’ jobs easier. A calm, secure child is easier to evaluate, diagnose and treat. Pave the way for better exams, treatment and outcomes by making comfort a top priority. The road to recovery will be far smoother.

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