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1201

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Medicine

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Feb 20, 2024

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when it comes to any form of Pediatric Care the health and well-being of the young patient is always the first priority and that does not change when it comes to radiologic Imaging Radiology as a whole is primarily known for producing really cool x-rays that shows parts of our bodies that we cannot see from the outside this includes our bones brain parts of our organ systems like our kidneys liver and more what a lot of people do not know however are the dangers and risks that come with x-rays the most important thing when it comes to acknowledging the risks of X-rays and CT scans is knowing what makes these machines potentially hazardous these tools work by using ionizing radiation which operate by using particles of light to remove electrons from molecules of materials that we cannot see these materials can be air water and living tissues which include our skin without the proper care and without the proper dosage of radiation a few things can happen one of the major ways that radiation can potentially affect the patient is by changing their DNA by inducing DNA breaks and or single strand breaks from the ionizing radiation if the dosage is too high a patient can be diagnosed with acute radiation syndrome or more commonly known as radiation sickness a patient can also suffer from radiation Burns which in severe cases is usually named radiation dermatitis so with all of these risks when it comes to radiologic Imaging our predecessors realize that the radiologic standards for children should not be the same as adults a big reason being that the thickness of skin compared to an adult is not the same as on a child which means radiation can penetrate the child's game far easier due to it being thinner
our predecessors knew that the dosalara or as low as reasonably achievable dosage of radiation had to be much lower when it comes to radi when it comes to Imaging children this led to radiologies wanting to protect kids as best as they can if they need an x-rays or CT scans or any other procedure involving ionizing radiation because of the innate need to protect image gently was founded and created in 2007 to promote safe Imaging in children their mission statement reads as follows the mission of the Imaging Alliance is through advocacy to improve safe and effective Imaging care of children worldwide image gently was founded by what I like to call the four founding parent organizations these organizations include the society for Pediatric Radiology the American College of radiology the American Society for radiologic Technologies and the American Association of physicists and Medicine even though a lot of these organizations and even image gently itself was founded in America image gently is a global organization with ties in New Zealand Britain Italy Australia India and Argentina just to name a few their main goal is to raise awareness of the multitude of opportunities that are made available to lower the dosage of radiation while Imaging children on the msgently website there's a plethora of information for not only technologies that are entering the Radiology field but for physicists and parents as well this is a great way to help parents understand what exactly is happening during the Imaging process so that there is less concern and they feel a bit more content with knowing what's happening they have specifications for computed
tomography Interventional procedures nuclear medicine and ultrasounds overall image generally is a great source in program when it comes to advocating for the safe Imaging of our children there's plenty of information that can be found on their website msgently.org all of this is to help parents and technologists alike help to protect children and provide them with the best possible care Medical imaging is widely used in the diagnosis and management of many medical conditions. Imaging often utilizes radiation, and this exposure raises questions and concerns from patients and providers alike. When considering medical options, providers need to clearly explain potential risks and benefits, critically appraise the available literature for evidence-based recommendations, positively influence their healthcare team’s actions and share the informed decision-making process with their patient and family. This innovative module utilizes radiation protection in children as a framework to emphasize: layperson terminology as a crucial bridge to close the health literacy gap, clinical decision support and critical appraisal skills to encourage evidence-based practice, motivational interviewing to empower learner-directed change with patients and colleagues, and shared decision-making to promote respectful healthcare. The Image Gently Family-Friendly Campaign module is a free interactive learning experience, built by an interprofessional, interdisciplinary team made up of Family Medicine and Pediatric Radiology physicians, radiology technologists, medical physicists, health professions educators and medical students. The module was ideally designed for medical students in their Family Medicine clerkship. It would also fit well within a Pediatrics clerkship or a Radiology rotation. However, we expect that it could be beneficial for residents and attending physicians, alike. We anticipate it will take one hour to complete the course. 1. Children are smaller than adults.  For any given set of CT scanning parameters, the effective dose is higher for smaller cross-sectional areas. This is because dose is defined as absorbed energy per unit mass, and therefore the same energy in a smaller mass will result in a higher dose per unit mass. In addition, in the case of CT, where the beam is applied circumferentially, dose in the center of a small patient will be higher than in the center of a large patient, due to the lesser attenuation of the surrounding tissue in a small patient. These effects will be most pronounced in the youngest patients with smaller body mass and radius. Calculated dose parameters that are displayed in current CT scanners are based on data
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obtained from the 32 cm phantom. In an average adult, whose size is equivalent to 29 cm, the 32 cm acrylic phantom will underestimate the dose to that average adult by approximately 30% [10]. This, of course, would be compounded in pediatric patients. In an analysis of effective dose by body mass, effective dose in pediatric patients was increased by 50% compared to adult patients despite a reduction of approximately 25% in scanning parameters in that series. The increase was most marked in the infants, in whom effective dose increased 100% [10]. It is therefore very important to realize that, for a given set of CT scanning parameters, we must CHILD-SIZE the scanning parameters just to maintain the same image noise that is acceptable in the CT images of our adult patients. 2. Children are growing.  Because of this, their tissues are more radiosensitive than adult tissue. According to the International Commission on Radiation Protection (ICRP), estimates of attributable lifetime risk for a single dose of radiation vary considerably with age, are increased in patients younger than 30 years, but particularly in patients younger than 10 years [11]. With the exception of leukemia, girls are also believed to be more radiosensitive than boys for most cancers, particularly breast and thyroid. This increased radiosensitivity is believed to be related to other promoting factors which are hormone-dependent and which differ between males and females, rather than to other potential inherent differences in radiation sensitivity