Keeping Children Still in Medical Imaging Examinations- Immobilisation or Restraint: A Literature Review

• Published in: Journal of medical imaging and radiation sciences Vol. 50; no. 1; p. 179
• Main Authors: Ng, Jessica Hui Shi, Doyle, Edel
• Format: Journal Article
• Language: English
• Published: United States 01.03.2019
• Subjects: medical imaging; Immobilisation; paediatric; restraint
• DOI: 10.1016/j.jmir.2018.09.008

In paediatric imaging, it is common practice to hold children still for an examination by using immobilisation devices, parents, and/or staff. Historically, there has been a perceived need to restrain a child against their will when uncooperative behaviour was demonstrated. The issue of patient consent and use of physical force forms this fundamental difference between "immobilisation" and "restraint". To avoid unknowingly "restraining" a child, the factors affecting a radiographer's decision to "restrain" are explored in this literature review from a child's rights and radiation protection perspective. Literature searches were performed using the primary keywords "paediatric", "immobilisation", "restraint", and "medical imaging". Titles, abstracts, and full texts were screened for their relevance and resulted in 16 articles to address the aims of this literature review. The literature discussing immobilisation and restraint in paediatric imaging includes 16 articles published between 1980 and 2017. The literature findings were categorised, analysed, and discussed under the five subtopics: definitions of immobilisation and restraint, consent and children's rights, paediatric radiation protection, radiation dose to parents and staff, and the future implications of restraint in medical imaging. Many factors, including the justification of the examination, the rights of the child, the child's cooperative ability, and the radiation doses to the patient and accompanying persons, mean the decision to restrain may be a difficult one to make. The introduction of guidelines and training in Australia would prove useful in assisting this decision-making process. An individual assessment of the child's best interests and family's needs must be considered; however, restraint should ideally be avoided unless justified through a risk-benefit analysis.