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Child life prep REdUCES NEED FOR sedation

Pat Frasca in the Diagnostic Imaging department. Pat Frasca with the Diagnostic Imaging's scale model MRI machine.

 



 

Diagnostic Imaging's new Child Life specialist uses preparation to reduce the need for sedation during MRIs and CT scans

Child Life preparation for procedures, a long-time Surgery department mainstay at Children's Hospital, is now part of our Diagnostic Imaging department as well after in-house research confirmed it reduces the need for sedation. In the May/June 2006 study, all 30 patients tested got through Diagnostic Imaging procedures without sedation. 

Children's Child Life specialist, Pat Frasca, has set up shop in Diagnostic Imaging 40 hours a week, preparing 6- to 13-year-olds for MRIs and 4- to 8-year-olds for CT scans. “My goal is to minimize each child’s stress and anxiety; that’s why I choose developmentally appropriate ways to prepare each patient.”

Pat helps children express their concerns and offers them techniques to manage anxiety during the procedure. For MRIs and CT scans some kids like listening to music or stories, and others prefer daydreaming. For IV starts, Pat teaches children and their caregivers distraction and relaxation techniques.

With many, Pat works on breathing. “What do we usually do when we are worried or anxious?” asked Pat. “We hold our breath. But breathing is the most powerful way to manage fear.”

Helping kids experience mastery over medical procedures is her goal, said Pat. Preparation and medical play help them and their parents cope with the overall healthcare experience. Parents with little medical background can learn language and techniques to use at home.

One of Pat’s most useful tools is the scale model MRI built by volunteer Jensen Young. Kids can examine it, play with it and even place a doll in it and perform their own MRI or CT scans

A mini MRI machine
Joseline places a doll in the model MRI machine Pat uses to help kids prepare for their procedures. The model has sound effects and a sliding table.

Diagnostic Imaging’s medical director, Ronald Cohen, MD, is pleased to have a Child Life specialist join the department. “It’s important to do what we can to improve the experience of the children who need diagnostic imaging,” said Dr. Cohen. “Child life specialists help reduce the anxiety of our young patients and their parents.”

He pointed out that preparing children to be sedated for a Diagnostic Imaging procedure can be an ordeal. The child needs a physical exam, may need to go without food till the procedure, may need an IV for administering the sedating medication and needs recovery time afterwards. “It’s a lot of time and a lot of expense that can be avoided if the exam is performed without sedation or anesthesia,” said Dr. Cohen.

The department’s assistant head nurse, Nigel Lucas, RN, is also convinced Child Life techniques work. After 16 years in nursing, including the last four in Diagnostic Imaging, he’s now “becoming an advocate for Child Life. It makes for a better working environment for everybody.”

Nigel has observed that Diagnostic Imaging staffers working with Pat are picking up her Child Life techniques for easing the patient and family experience.

Pat said that when time permits, she also provides preparation and support for other procedures. For example, Nigel has observed Child Life preparation helping patients needing fluoroscopy exams used during voiding cystourethrograms.

“We were delighted that hospital administration recognized our efforts and supported a new Child Life position in Diagnostic Imaging based on these findings,” said Mary Kelly, manager, Child Life Services. “Most important of all, it is an opportunity to make the hospital experience better for our patients and families.”

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