Calming the child before the scan

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According to Omar Mahmood, Principal Radiographer (above right), children under eight generally will fidget a lot during the scan and are afraid of the MRI machine.

SINCE the MRI suite became more child-friendly, fewer children need sedation before a scan.

A child who needs a Magnetic Resonance Imaging (MRI) scan steps into a frightening world dominated by an intimidating machine. But at KK Women’s and Children’s Hospital (KKH), the MRI suite looks more like a children’s playground.

The suite is decorated with a jungle theme. There are animal murals on the wall, a 3D toy MRI machine to play with before the scan, and animated movies on TV that they can watch during the scan. Mum or Dad can also stand close by in the scan room and talk to them through a plastic hose – a novel idea that the nurses came up with, as electronic equipment is not allowed inside the suite.

This is not just fun and games. There is a serious intent behind it – to reduce the need to put children under sedation during the scan. For children under eight, this means being under general anaesthesia.

The child-friendly measures have worked. Since introducing these initiatives, the hospital has seen the number of children under eight who need sedation drop by 25 per cent.

 

Look Ma – no sedatives!

Mr Omar Mahmood, Principal Radiographer, Department of Diagnostic & Interventional Imaging, KKH, said children aged eight and below generally need sedation because they are either afraid of the MRI set-up, or cannot keep completely still for 30 minutes. He said: “We need them to be very still and cooperate for half an hour. If they move, the radiographer will have to repeat that particular segment again, prolonging the session. Our experience is that only about one out of 50 children under eight will stay still for the procedure. Most will fidget a lot and are afraid of the machine.”

By preparing children psychologically for the procedure, the staff have found that they can have some measure of success. The department’s two MRI machines cater for women and children, and about 30 per cent of its patients are under eight.

One MRI scan room has a spaceship theme done up by staff in 2008. The jungle-themed room was set up in 2012 but only decorated last year. A professional artist was commissioned to create the vinyl decals of zebras, pandas and macaws in a bid to make the room more child-friendly.

Preparation starts the minute a child walks in and registers. He changes into a gown with cartoon motifs. Staff, dressed in uniforms that also bear cartoon motifs, then introduce the child to the toy MRI machine, and show him what will take place during the scan.

The toy is actually a 3D model specially customised for KKH to look and sound like the real thing. The child can slide the toy patient in and out of the tunnel and get used to the whirring sound it makes – the same sound that the real machine makes during the actual scan. The whole preparation period takes about 20 minutes.

Next comes the trial session in the MRI machine. To help him keep still, the child can watch his favourite movies on a custom-made TV, which is magnet-safe.

There are also soft toys for him to hold on to and although he cannot see his parents or hold their hands, he can hear their voices through the plastic hose, and talk to them as they wait near the machine.

 

This story was first published in Singapore Health, May/June 2014.