RESUMO
INTRODUCTION: Brain imaging for suspected significant head injuries in pediatric emergency departments is an important and time-sensitive procedure. The use of sedation to successfully complete imaging can be limited due to young age and other injury related factors. Using a non-pharmacological method using feeding and swaddling can be used. This may obviate the need for sedation but can be time consuming. METHODS: A retrospective study of all children undergoing brain imaging for head injury during the years 2016-2021. Use of sedation, time to completion and imaging findings were compared. RESULTS: Of 281 children requiring brain imaging, 268 (95.4%) were completed using the feed and swaddle method. Time to imaging completion was similar between sedation and feed and swaddle groups (85.5 min vs. 86 min). Abnormal findings on imaging were found in 186 (69.4%) in the feed and swaddle group and in 10 (77%) of the sedation group. No adverse events were seen in the sedation group. CONCLUSION: Using the feed and swaddle method can help lower the need for sedation in the under 1 year age group with a successful and timely completion of brain imaging.
Assuntos
Traumatismos Craniocerebrais , Tomografia Computadorizada por Raios X , Traumatismos Craniocerebrais/diagnóstico por imagem , Serviço Hospitalar de Emergência , Humanos , Hipnóticos e Sedativos/uso terapêutico , Lactente , Estudos Retrospectivos , Fatores de Tempo , Tomografia Computadorizada por Raios X/métodosRESUMO
The feed and wrap technique refers to the use of feeding and swaddling to induce natural sleep in infants. It can be used prior to an magnetic resonance imaging (MRI) scan, avoiding sedation or anesthesia. We performed a retrospective review of feed and wrap MRI scans in infants 3 months or younger over a 2-year period at our center (279 scans) to evaluate the efficacy of this technique. Of scan results reviewed, 79% addressed the clinical question, 20% partially addressed the clinical question, and 1% were technically inadequate. History of preterm birth (odds ratio [OR] = 2.368; P = .032) and spine MRI (OR = 2.821; P = .001) were associated with a less-successful scan outcome. The feed and wrap technique can be used successfully in infants undergoing MRI; however, it may be less successful in preterm infants and those requiring spinal MRI. A standardized technique performed by experienced personnel may avoid anesthesia and sedation in infants who require MRI.