Ethical Dilemmas
Recently the number of infants and children I’m scanning seems to be increasing. This population presents many challenges for me and my co-workers. How do you get an infant to stop crying and hold still long enough to get a diagnostic study? How do you deal with the scared parent(s)? Also, is a CT scan really the best option for a child due to the high levels of radiation?
I have found that swaddling an infant as tight as possible and allowing the parent to stay in the room, shielded of course, is a great option. Even if the infant closes her eyes she still knows her mother or father is nearby and this brings her great comfort. This is also helpful for the parents because they can see that their child is okay. Despite the fact that the child is the patient, the parent needs just as much attention and care. Often just a few reassuring words, a pat on the back, and a reassuring smile can do wonders.
There are many debates over the use of protective lead shields for patients receiving a CT. This makes it difficult for me as a technologist because we are taught to first do no harm. Some say that the shields trap the harmful 360 degree radiation and others contend that the shields provide adequate protection, just like they do in diagnostic x-ray. I’m not sure what to believe so I will continue to read more on the subject.
And one final ethical concern I’ve encountered is how I feel about scanning a pregnant woman. Last week I scanned a young woman in her early 20’s who was eighteen weeks pregnant. She had signed the numerous consents, discussed the risks with her physician, and didn’t seem concerned about her pending CT. We also had to administer rectal contrast to her. The lead technologist told me that if she was any further along in her pregnancy it would be best to have the Radiologist give the contrast to make certain no harm comes to the fetus.
Each patient presents with special issues I have to take into consideration before the scan begins. I always take my time and assess any risk factors or special concerns that could potentially put the patient or the family in harm’s way. Being a good listener and staying in tune with the patient’s body language are keys to a happy patient and a successful scan.