A three twelvemonth old male child was admitted on to the ward during a dark displacement after go toing the Accident and Emergency section with hurting in his left leg after stumbling over a plaything at place. On scrutiny the patient ‘s leg showed seeable swelling around his mortise joint and the male child had great trouble seting force per unit area on the country and was unable to walk as a consequence. Beaty & A ; Kasser ( 2006 ) suggest that these symptoms indicate that an X ray is the best class of action in this instance. The initial suspected cause put frontward by the medical squad was that the kid may hold suffered a sprained mortise joint, nevertheless a referral to the x-ray section was made as farther probe was needed to find the badness of the hurt and confirm that the hurt was non a break or interrupt bone and let the right intervention to be initiated by the nursing staff. An X ray was the most suited technique in this case as an X ray can “ go through easy through low-density stuffs, such as soft tissue, but less easy through heavy stuffs such as bone ” ( Jones & A ; Taylor 2006 ) . Detecting the exact type of hurt the kid has by executing an X ray can besides assist to verify or discredit the account given by the kid ‘s male parent on admittance, something that could be cardinal grounds in a suspected kid protection instance. McRae and Esser ( 2008 ) emphasis the importance in sing child maltreatment issues, particularly when presented with an hurt of this magnitude in a kid under three old ages old, as they suggest that 80 per centum of admittances of this nature will be as a consequence of kid maltreatment.
An X ray, besides known as a radiogram, “ involves exposing a portion of the organic structure to a little dosage of ionizing radiation to bring forth images of the interior of the organic structure ” ( RSNA 2010 ) . These images are produced when negatrons hit the focal point country, in this case the kid ‘s leg. Some of the energy is released as heat and the remainder signifier x-rays which will concentrate on the affected country and base on balls through to organize an image of the bone on movie ( Jones & A ; Taylor 2006 ) .
The benefits of an x-ray far outweigh the hazards in most instances ( Sherer, Ritenour and Visconti, 2006 ) . To this twenty-four hours x-rays remain one of the most widely utilized methods of observing broken or fractured castanetss. The radiographic equipment can be found in most Accident and Emergency sections every bit good as being widely available out in the community. One of the grounds that X raies are so widely used is that they are inexpensive to run and there are no existent physical side effects for the patient afterwards. Because x-ray imagination is fast and easy, it is peculiarly utile in exigency diagnosing and measuring the effectivity of intervention. As x-ray scrutinies are a non invasive diagnostic tool they normally have no side effects as the radiation passes through the organic structure and does non stay at that place ( RSNA 2010 ) .
Although there are more benefits to X raies than hazards there is ever a little opportunity of a patient being exposed to radiation and cellular harm happening. Sherer et. Al ( 2006 ) province that in order to safeguard patients, every bit good as the radiographers and visitants, the right protective steps should be in topographic point. In order to protect the radiographer during the x-ray there is a control booth-barrier that they are required to stand behind whilst the images are being taken. Protective lead aprons are available to those attach toing the patient and lead is besides used to screen the country of the patient being x-rayed. This lead will cut down the sum of radiation exposure the patient receives if it is placed right near to the country ( Boynes & A ; Hardy 2003 ) . Patients undergoing an X ray will be asked to take any pieces of jewelry as metal may interfere with the equipment as the metal absorbs the x-rays and will look on the x-ray image, potentially blockading a job.
X raies can in some cases fail to pick up some types of hurts and there may be a demand for an alternate diagnostic process. Whiteing ( 2008 ) states that “ while an X-ray in most instances is able to demo a cadaverous hurt, it is non able to demo cut off nervousnesss, crushed musculuss, ruptured blood vass or lacerate ligaments, how the hurt occurred or how it should be treated ” . In some instances Magnetic Resonance Imaging ( MRI ) or Computed Tomography ( CT ) scans may turn out to be a more effectual diagnostic tool. An MRI scan can observe a bruised bone that an X ray will non descry. In contrast a CT scan can image complicated breaks, elusive breaks or disruptions that may be excessively complex or easy missed on an x-ray. Sound waves used in the topographic point of radiation can besides make images, which can be utile for naming hurts around the articulations ( RSNA 2010 ) . Fortunately the medical squad was able to do a diagnosing on this juncture based entirely on the x-ray as it was clear and no alternate diagnostic technique was required. It is indispensable for the nurse to be unfastened and honest about both the benefits and hazards of an x-ray so that the patient and their household have all of the information available to them. In the illustration given the benefits and hazards of the process were given by the nursing staff and in the appropriate literature provided to the kid ‘s male parent.
Nursing staff should make their best to fix a kid for any processs they will digest whilst they are in infirmary, nevertheless fixing a kid for ten ray process is non an easy thing to make particularly at such a immature age. Harmonizing to Piaget a three twelvemonth old kid will hold really small apprehension of hospital environments and unwellness and therefore will be unable to to the full understand what will go on to them during the x beam.
A nurse should take the clip to explicate the process to the kid as many times as is needed as the kid will non take in all the information at one time, therefore they will still be frightened by the process. This communicating is indispensable if maximal co-operation is to be achieved and the usage of physical restraints minimised. If restraint is needed it should be minimum and used as a last resort as it could potentially add to the kid ‘s disquieted. Bland ( 2002 ) topographic points accent on the fact that “ nurses have a duty to supply appropriate methods of restraint when project processs, guaranting the kid ‘s safety and cut downing unneeded hurt. ” Giving the kid ‘s parents the option to remain with the kid throughout the process may assist to cut down the torment of both the parents and kid. The machinery can be really scaring to a immature kid and their parents presence can assist to ease their fright. It may even be possible for a portable X ray to be carried out on the ward which would besides ease the kid ‘s emphasis supplying the right safety guidelines are followed.
Judge ( 2007, cited in Whiteing 2008 ) states that “ preemptive analgesia should be provided so that patients ‘ hurting is sufficiently managed earlier and during process ” . This can assist the kid to experience more comfy as positioning the kid ‘s leg for X ray may do them trouble. In bend, if the analgesia is effectual the kid is more likely to co-operate with the nursing staff and the demand for restraint is reduced. The writer besides states that some “ non-pharmacological methods of hurting control such as placement and distraction techniques may besides be effectual in ( Judge 2007, cited by Whitening 2008 ) . Foam cuneuss are widely available in x-ray sections and can be used to back up the leg during the process, alleviating some of the uncomfortableness for the kid. However, it can turn out hard seeking to deflect a kid when they are in hurting and they are required to stay every bit still as possible, as was the instance with the three twelvemonth old as he was rushed to x-ray shortly as possible with no existent clip for distraction techniques to be carried out.
Glasper, McEwing and Richardson ( 2008 ) suggest that “ function drama is peculiarly utile when enabling kids who do non hold the necessary linguistic communication and/or cognitive accomplishments to develop an apprehension of the process and familiarize them with the equipment ” . If the kid has brought a doll or teddy into infirmary with them it may be a good thought to convey the plaything along to the X ray. Time allowing, the nurses or drama specializers on the ward could move out what will go on to the kid during the X ray on the plaything. This degree of readying is non ever possible on busy wards due to clip restraints on the wards, staff deficits and when an ten beam slot is booked directly off following an exigency admittance, as was the instance in this scenario. At the really least in order to reassure the parents and child it is of import that they are given as much information as possible for them to make an informed determination about a process and give their consent. All benefits and hazards should be conveyed to the patient and an ‘explanation of the process should be made in a friendly mode ‘ ( Boynes & A ; Hardy ) .
The Picture Archiving and Communication System ( PACS ) was designed to better the quality of x-ray images and replace the usage of movie images. There are many benefits of utilizing the PACS system for both patients and the medical staff ( NHS 2010 ) . As the images are stored digital they can be accessed at any clip and are delivered faster in between sections, taking to better communicating between the sections and a fleet diagnosing to be made and authorized directly off. This is besides utile as movie X raies are often misplaced in infirmaries as they are passed around between the sections. The images on screen can be manipulated, leting for a better quality image and a clearer image. Instantaneous entree to historic images and patient records besides gives the medical squad the ability to compare older and recent X raies for marks of betterment or impairment in the patients status ( NHS 2010 ) .
The kid in this scenario was diagnosed with holding a closed hairline break of the shinbone, a common inadvertent hurt among kids around this age of development when they are prone to falls as they start to happen their pess ( Glasper et al. 2006 ) . This diagnosing was achieved as a direct consequence of the x-ray, without this the hurt may hold been treated as though it were a sprain, perchance doing more harm. However, if the break had been more complication there is a opportunity that the X ray may non hold picked up the hurt. The process was really nerve-racking for the kid so it was of import that analgesia was given and the kid ‘s male parent was encouraged to remain with him through out. On this juncture distraction techniques were non a possibility due to the clip of admittance and the sum of hurting the kid was in but it is a really effectual method. Above all it is the duty of the medical staff to work together and pass on efficaciously to guarantee that best pattern is followed so that any diagnostic process undertaken is every bit stress-free as possible for patients and in their best involvements.