Aims Diagnostic imaging procedures such as Magnetic Resonance Imaging (MRI) can be long procedures and involve a confined environment.¹ Studies suggest that up to two-thirds of children undergoing MRI experience anxiety.² This has led to the use of sedation to facilitate successful imaging outcomes, particularly in children under six years of age.

The aim of this study is to assess the impact of play and education (P&E) prior to imaging procedures and its effectiveness in avoiding sedation.

Methods

• Play and education preparation involved explaining the proposed procedure to the child verbally, pictorially and using a model MRI unit if appropriate.

• Information was collected on children between the ages of 3–5 years who underwent P&E in preparation for imaging procedures, from 2013–14

• A successful imaging procedure was judged to be that which resulted in adequate images for diagnostic purposes.

Results The data set included 66 patients with normal development between 3–5 years of age who underwent diagnostic imaging procedures in 2013–14.

• 27 patients of these were referred for P&E preparation based on nursing assessment of potential to avoid sedation. Of these, 24 were successful with this preparation alone.

• In comparison, during the same time 39 patients underwent an MRI scan with oral or IV sedation.

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Abstract G318 Figure 1

Success rate of P&E vs sedation in age group 3–5 yrs in 2013 and 2014

Conclusions

• We have demonstrated that simple psychological techniques using play and education prior to imaging procedures can reduce the need for sedation in paediatric patients as young as 3 years of age.

• Assessment to use P&E rather than sedation in the first instance, was based on child’s maturity and anxiety level and was done subjectively by staff with parental help.

• Given the success of play and education it may be that more patients should be offered this first before progressing to sedation.

• The play and education techniques used are inexpensive and require the time of a play specialist alone.

• These techniques can be replicated in any paediatric ward, day unit or outpatient clinic that refers paediatric patients for diagnostic imaging, in particular MRI.

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Abstract G318 Table 1

Data for 3–5 year olds in 2013 and 2014

References

1. Marshall SP, Smith MS, Weinberger E. Perceived anxiety of paediatric patients to magnetic resonance imaging. Clin Pediatr 1995; 34 :59–60

2. de Amorim e Silva CJT, Mackenzie A, Hallowell LM, Stewart SE, Ditchfield MR. Practice MRI: Reducing the need for sedation and general anaesthesia in children undergoing MRI. Australasian Radiology 2006; 50 :319–23