Procedural pain reduction strategies in paediatric nuclear medicine

Kohli, Mandy L; Vali, Reza; Amirabadi, Afsaneh; Frankfurter, Caroline A; Nateghi, Ardavan; Marie, Eman; Shammas, Amer

doi:10.1007/s00247-019-04462-w

Cited by 4 publications

(5 citation statements)

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“…To minimize the patient’s distress and muscle tension, and for radiation safety reasons, a peripheral intravenous access should be obtained in advance. Anesthetic cream should be used to minimize pain and distraction methods can be used to decrease the patient’s stress ( 59 ). If a central line or Porth-a-Cath has to be used for tracer injection (due to difficult peripheral intravenous access), the line should be flushed with a sufficient amount of normal saline solution.…”

Section: Procedure/specifications Of the Examinationmentioning

confidence: 99%

SNMMI Procedure Standard/EANM Practice Guideline on Pediatric¹⁸F-FDG PET/CT for Oncology 1.0

et al. 2020

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PREAMBLE The Society of Nuclear Medicine and Molecular Imaging (SNMMI) is an international scientific and professional organization founded in 1954 to promote the science, technology, and practical application of nuclear medicine. The European Association of Nuclear Medicine (EANM) is a professional nonprofit medical association founded in 1985 to facilitate communication worldwide among individuals pursuing clinical and academic excellence in nuclear medicine. SNMMI and EANM members are physicians, technologists, and scientists specializing in the research and practice of nuclear medicine. The SNMMI and EANM will periodically put forth new standards/guidelines for nuclear medicine practice to help advance the science of nuclear medicine and improve service to patients. Existing standards/guidelines will be reviewed for revision or renewal, as appropriate, on their fifth anniversary or sooner, if indicated. Each standard/guideline, representing a policy statement by the SNMMI/EANM, has undergone a thorough consensus process, entailing extensive review. The SNMMI and EANM recognize that the safe and effective use of diagnostic nuclear medicine imaging requires particular training and skills, as described in each document. These standards/guidelines are educational tools designed to assist practitioners in providing appropriate and effective nuclear medicine care for patients. These guidelines are consensus documents, and are not inflexible rules or requirements of practice. They are not intended, nor should they be used, to establish a legal standard of care. For these reasons and those set forth below, the SNMMI and the EANM cautions against the use of these standards/guidelines in litigation in which the clinical decisions of a practitioner are called into question. The ultimate judgment regarding the propriety of any specific procedure or course of action must be made by medical professionals taking into account the unique circumstances of each case. Thus, there is no implication that action differing from what is laid out in the standards/guidelines, standing alone, is below standard of care. To the contrary, a conscientious practitioner may responsibly adopt a course of action different from that set forth in the standards/guidelines when, in the reasonable judgment of the practitioner, such course of action is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology subsequent to publication of the standards/guidelines. The practice of medicine involves not only the science, but also the art of dealing with the prevention, diagnosis, alleviation, and treatment of disease. The variety and complexity of human conditions make it impossible for general guidelines to consistently allow for an accurate diagnosis to be reached or a particular treatment response to be predicted. Therefore, it should be recognized that adherence to these standards/guidelines will not ensure a successful outcome. All that sho...

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Section: Procedure/specifications Of the Examinationmentioning

confidence: 99%

SNMMI Procedure Standard/EANM Practice Guideline on Pediatric¹⁸F-FDG PET/CT for Oncology 1.0

et al. 2020

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“…To reduce pain and anxiety and for radiation protection purposes, intravenous access should be pre-planned whenever possible. Anesthetic cream (containing lidocaine and prilocaine) can be applied 1 hour prior to venous access [ 2 , 8 , 40 ]. If an intravenous cannula is already available, it should be used for tracer injection, and the line flushed with sufficient saline solution.…”

Section: Preparation Premedication and Injectionmentioning

confidence: 99%

“…In children, the fear and the pain due to venipuncture are potential causes of failure in diagnostic procedures. Evidence-based guidelines and reviews have been written to identify strategies to reduce painful sensation or distress [ 40 , 62 – 64 ]. Multimodal analgesia approaches should be proposed and premedication anticipated.…”

Section: Anxiolysis Pain Management and Sedationmentioning

confidence: 99%

“…Non-pharmacological options should also be considered to reduce pain, such as massage, heat compresses, ice packs, and repositioning. When medications are used, it is demonstrated that the combination of two methods, pharmaceuticals (e.g., topical liposomal lidocaine cream) and adjuvants (e.g., instant topical anesthetic skin refrigerant or oral sucrose), is more effective for pain management compared to only one method [ 40 ].…”

Section: Anxiolysis Pain Management and Sedationmentioning

confidence: 99%

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EANM procedural recommendations for managing the paediatric patient in diagnostic nuclear medicine

Camoni

Santos

Luporsi

et al. 2023

Eur J Nucl Med Mol Imaging

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Purpose The manuscript aims to characterize the principles of best practice in performing nuclear medicine procedures in paediatric patients. The paper describes all necessary technical skills that should be developed by the healthcare professionals to ensure the best possible care in paediatric patients, as it is particularly challenging due to psychological and physical conditions of children. Methods We performed a comprehensive literature review to establish the most relevant elements of nuclear medicine studies in paediatric patients. We focused the attention to the technical aspects of the study, such as patient preparation, imaging protocols, and immobilization techniques, that adhere to best practice principles. Furthermore, we considered the psychological elements of working with children, including comforting and distraction strategies. Results The extensive literature review combined with practical conclusions and recommendations presented and explained by the authors summarizes the most important principles of the care for paediatric patient in the nuclear medicine field. Conclusion Nuclear medicine applied to the paediatric patient is a very special and challenging area, requiring proper education and experience in order to be performed at the highest level and with the maximum safety for the child.

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“…Before injection of the radiopharmaceutical, the procedure should be explained to caregivers and children old enough to understand. A topical anesthetic cream may be used at the discretion of the patient and their caregiver [50]. When used, it should be applied to the injection site 30-60 min prior to accessing the vein.…”

Section: Preparation Prior To Injection Of the Radiopharmaceuticalmentioning

confidence: 99%

SNMMI procedure standard/EANM practice guideline on pediatric [99mTc]Tc-DMSA renal cortical scintigraphy: an update

Vali

Armstrong

Bar-Sever

et al. 2022

Clin Transl Imaging

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The Society of Nuclear Medicine and Molecular Imaging (SNMMI), founded in 1954, is an international scientific and professional organization with a purpose to promote the science, technology, and practical application of nuclear medicine. The European Association of Nuclear Medicine (EANM), founded in 1985, is a nonprofit professional medical association with a purpose to facilitate international communication among individuals in nuclear medicine pursuing clinical and academic excellence. Members of the SNMMI and EANM are physicians, technologists, and scientists who specialize in the research and practice of nuclear medicine. The SNMMI and EANM will periodically publish new guidelines for nuclear medicine practice to further advance the science of nuclear medicine and improve patient care. Existing standards/guidelines will be reviewed for revision or renewal, as appropriate. Each standard/guideline, representing a policy statement by the SNMMI/EANM, has undergone a thorough review, and represents an expert consensus. The SNMMI and EANM recognize that the safe and effective use of diagnostic nuclear medicine imaging requires specific training and skills, as described in each document. These standards/guidelines are educational resources designed to assist practitioners in providing appropriate nuclear medicine care for patients. They are consensus documents, and are not mandatory provisions or requirements of practice. They are not intended, nor should they be used, to establish a legal standard of care. For these reasons and those set forth below, the SNMMI and the EANM cautions against the use of these standards/guidelines in litigation procedures that call into question the clinical decisions of a practitioner. The ultimate judgment regarding the appropriateness and propriety of any specific procedure or course of action must be made by medical professionals, taking into account the unique context of each case. Thus, there is no implication that action differing from what is detailed in these standards/guidelines, on its own, is below the standard of care. On the contrary, a conscientious practitioner may responsibly adopt a course of action different from that set forth in the standards/guidelines when, based on the reasonable judgment of the practitioner, such course of action is warranted based on the condition of the patient, limitations of available resources, or advances in knowledge or technology subsequent to publication of the standards/guidelines. Practicing medicine involves not only the science, but also the art of dealing with the prevention, detection, diagnosis, and treatment of disease. The variety and complexity of human conditions make it impossible for general guidelines to consistently allow for an accurate diagnosis to be reached or a specific treatment response to be predicted. Therefore, it should be recognized that adhering to these standards/guidelines does not ensure a successful outcome. All that should be expected is that a practitioner follows a reasonable course of action based on their level of training, the current landscape of knowledge, the resources at their disposal, and the needs/context of the particular patient being treated. The purpose of this document is to provide nuclear medicine physicians, radiologists, and other clinicians with guidelines for the recommendation, performance and interpretation of 99mTc-dimercaptosuccinic acid renal cortical scintigraphy ([99mTc] Tc-DMSA scintigraphy) in pediatric patients. These recommendations represent the expert opinions of experienced leaders in this field, and these recommendations are not all supported by a high level of evidence. Further studies are required to have evidence-based recommendations for the application of [99mTc] Tc-DMSA renal cortical scintigraphy in pediatrics. This guideline summarizes the views of the SNMMI Renal Cortical Scintigraphy in Children Working Group and the EANM Pediatrics Committee. It reflects recommendations for which the SNMMI and EANM cannot be held responsible. The recommendations should be taken into context of good practice of nuclear medicine and do not substitute for national and international legal or regulatory provisions.

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Procedural pain reduction strategies in paediatric nuclear medicine

Cited by 4 publications

References 10 publications

SNMMI Procedure Standard/EANM Practice Guideline on Pediatric¹⁸F-FDG PET/CT for Oncology 1.0

SNMMI Procedure Standard/EANM Practice Guideline on Pediatric¹⁸F-FDG PET/CT for Oncology 1.0

EANM procedural recommendations for managing the paediatric patient in diagnostic nuclear medicine

SNMMI procedure standard/EANM practice guideline on pediatric [99mTc]Tc-DMSA renal cortical scintigraphy: an update

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Procedural pain reduction strategies in paediatric nuclear medicine

Cited by 4 publications

References 10 publications

SNMMI Procedure Standard/EANM Practice Guideline on Pediatric18F-FDG PET/CT for Oncology 1.0

SNMMI Procedure Standard/EANM Practice Guideline on Pediatric18F-FDG PET/CT for Oncology 1.0

EANM procedural recommendations for managing the paediatric patient in diagnostic nuclear medicine

SNMMI procedure standard/EANM practice guideline on pediatric [99mTc]Tc-DMSA renal cortical scintigraphy: an update

Contact Info

Product

Resources

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SNMMI Procedure Standard/EANM Practice Guideline on Pediatric¹⁸F-FDG PET/CT for Oncology 1.0

SNMMI Procedure Standard/EANM Practice Guideline on Pediatric¹⁸F-FDG PET/CT for Oncology 1.0