Can pediatric radiography be practiced appropriately in a hospital, without a dedicated diagnostic imaging unit? A case study.

Introduction Due to Norway’s population density, demographic scatter and topography, performing radiological examinations in children in the same unit as in adults is quite common despite international guidelines recommending use of dedicated pediatric radiology units. Children examined in non-dedicated pediatric facilities are therefore a unique patient group who requires special attention. This study investigates pediatric radiography practice at a small local hospital lacking a dedicated pediatric radiology department by comparing it with the ideals of good practice as stated by international agencies. The aspects analyzed are organization, radiation safety and optimization. Methods The approach is qualitative, based on participant observation, document investigation and interviews with radiographers. Results Radiologists evaluated referrals. Age specific pediatric CT-protocols were being used. Awareness of the greater radiation risk in children and radiation safety concern were common among the radiographers.  Some radiographers had experience from pediatric imaging departments while none of them had postgraduate studies in pediatric radiography. Lack of extensive practice due to reduced pediatric patient volume makes sometimes the examination of children be a challenging task. Communication with children seemed to go well. Conclusion Despite variations in experience with children among radiographers and lack of specialization in pediatric radiography, the practice is largely in accordance with international recommendations. Radiation protection and optimization requirements met, although the departmental organization slightly diverges from prevailing guidelines. Slightly different practice and experience with children among radiographers indicate the need for special guidelines for pediatric imaging for non-dedicated pediatric radiology departments