Abstract
During the outbreak of the COVID-19 pandemic, guidelines have been issued by international, national and local authorities to address management and the need for preparedness. Children with COVID-19 differ from adults in that they are less often and less severely affected. Additional precautions required in the management of children address their increased radiosensitivity, need for accompanying carers, and methods for dealing with children in a mixed adult-paediatric institution. In this guidance document, our aim is to define a pragmatic strategy for imaging children with an emphasis on proven or suspected COVID-19 cases. Children suspected of COVID-19 should not be imaged routinely. Imaging should be performed only when expected to alter patient management, depending on symptoms, preexisting conditions and clinical evolution. In order to prevent disease transmission, it is important to manage the inpatient caseload effectively by triaging children and carers outside the hospital, re-scheduling nonurgent elective procedures and managing symptomatic children and carers as COVID-19 positive until proven otherwise. Within the imaging department one should consider conducting portable examinations with COVID-19 machines or arranging dedicated COVID-19 paediatric imaging sessions and performing routine nasopharyngeal swab testing before imaging under general anaesthesia. Finally, regular personal hygiene, appropriate usage of personal protective equipment, awareness of which procedures are considered aerosol generating and information on how to best disinfect imaging machinery after examinations should be highlighted to all staff members.
Highlights
Since the recent identification of a novel coronavirus, there has been the declaration of a global pandemic, with a seemingly uncontrolled daily death toll, currently standing at more than 133,000 worldwide [1]
Measures to prevent disease transmission during the COVID19 pandemic within paediatric radiology departments and in the course of radiologic procedures are of paramount importance
Paediatric radiology staff can make an appreciable difference by adhering to pragmatic guidelines for imaging children with suspected or confirmed COVID-19
Summary
Since the recent identification of a novel coronavirus (severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2, the infection coronavirus disease 2019 [COVID-19]), there has been the declaration of a global pandemic, with a seemingly uncontrolled daily death toll, currently standing at more than 133,000 worldwide (as of 15 April 2020) [1]. Children with suspected or confirmed COVID-19 requiring imaging either as a portable study or in the radiology department (e.g., CT, MRI, fluoroscopy) should wear a surgical mask. This may prove challenging for toddlers and babies, where exceptions may often be made. Where a suspected or confirmed COVID-19 patient requires imaging, this is preferentially performed as a portable study; if this is not possible, such as for CT or MRI, a designated COVID-19 machine (if resources allow) should be assigned to avoid disease transmission between different machines. The procedure should take place in the operating rooms under isolation restrictions, or alternatively, if resources allow, in a designated COVID-19 interventional room
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