(5) When verbal communication is possible, the instructions as to breathing
control should be as simple and short as possible. Remember that children have a very
short span of attention. When necessary, crying may be induced in infants and the
exposure made at the beginning of the cry.
e. Use of Contrast Media.
(1) For gastrointestinal examination of infants, approximately 4 ounces of
barium sulfate and 5 percent sterile glucose water should be prepared in sterile nursing
bottle. Several sterile nipples with openings of different sizes should be provided to
meet the demands of particular situations. The preparatory phase of the examination is
carried out according to clinical dictates. Usually, food and fluids are withheld
approximately 4 hours prior to examination. Incidental fluoroscopy and radiography will
be done according to the directions of the radiologist. In children over 2 years of age,
the examination is normally carried out in a manner similar to that for an adult.
(2) The contrast medium used for esophageal studies may be the same as
that used for gastrointestinal examinations. The contrast substance may be introduced
by ingestion from a nursing bottle or by way of a suitable catheter attached to a syringe
and transnasally inserted into the esophagus. Radiography is frequently limited to spot-
(3) For barium enema examinations, a suspension consisting of barium
sulfate and water is introduced under fluoroscopic control throughout the anus via a
suitable catheter. Retention of the contrast substance in the bowel may be facilitated by
holding the buttocks together with adhesive tape. Incidental radiography or spot-filming
is carried out according to the directions of the radiologist.
(4) The techniques for other contrast studies (such as intravenous and
retrograde pyelography, cystography, and urethrography) are essentially the same as
for adult patients. The chief difference is that the amount of contrast media used in
pediatric radiography is scaled to the size and age of the individual patient. In certain
examinations, infants and children under 5 years of age are examined on the horizontal
fluoroscopic or radiographic table.
f. Radiographic Measurements. Radiographic measurements for determining
the exact length of certain body structures, such as the long bones, may be done by
means of one of the orthoradiographic techniques.
g. Bone Age. At times, it is necessary to x-ray children to determine the bone
age. The x-rays are compared with growth charts found in many publications to find out
if the growth process varies from normal. The radiographs taken depend entirely upon
the radiologist. PA hands and wrists and dorsoplantar feet are commonly employed.
Others include AP projections of joints such as elbows, shoulders, hips, knees, and