The Image Gently campaign has developed the Pause & Pulse Initiative, a series of online teaching materials and checklists to help providers use the lowest dose necessary to perform fluoroscopic procedures on children.
Designed to promote radiation protection in fluoroscopy in children, the Pause & Pulse campaign was created, in part, as follow-up to a public meeting held by the FDA. "Fluoroscopy in children is a commonly performed study and there is a significant opportunity to decrease radiation dose for children, while still performing a diagnostic exam. These materials raise awareness and provide evidence-based educational materials to work toward this goal,” said Marilyn Goske, MD, chair of the Alliance for Radiation Safety in Pediatric Imaging.
When fluoroscopic procedures are indicated, providers, where appropriate, are urged to:
- Pause and child-size the technique (match kVp and mAs to size of child);
- Use lowest pulse rate possible;
- Limit fluoroscopic time and limit use of magnification mode;
- Carefully collimate area of interest and utilize appropriate shielding;
- Utilize pulsed digital fluoroscopic equipment with adjustable frame speeds and last image hold and capture capability; and
- Consider ultrasound or, when applicable, MRI.
“This extension of the Image Gently initiative gives providers real world, practical guidance to help ensure that the radiation dose administered to children via these procedures is as low as possible given the particular circumstances of each case,” said Marta Hernanz-Schulman MD, chair, American College of Radiology Pediatric Guidelines and Standards Committee.
Referring physicians are encouraged to ask the following of any imaging provider to whom they refer their pediatric patients:
- If the facility is accredited by the ACR;
- If the technologists are certified or licensed, and whether they have experience with children;
- How frequently the facility performs the requested fluoroscopic study in children; and
- If a board-certified radiologist with pediatric experience, or a pediatric radiologist will be performing and interpreting the study.
The Image Gently campaign is conducted by the Alliance for Radiation Safety in Pediatric Imaging, founded by the Society for Pediatric Radiology (SPR), the American College of Radiology (ACR), the American Society of Radiologic Technologists (ASRT), and the American Association of Physicists in Medicine (AAPM), and now encompasses more than 50 medical organizations serving more than 500,000 health care providers world-wide.
Click here for a downloadable presentation for use by providers to teach their staff methods to reduce dose and maintain quality.
Click here for a downloadable checklist of dose reduction steps the team should review for each patient.