Paediatric radiology in resuscitation and trauma
Children differ from adults in injury patterns, physiological reserve and radiosensitivity. Imaging in paediatric trauma must balance rapid diagnosis of life‑threatening injury with strict justification and dose optimisation.
Emergency clinicians should understand the roles and limits of bedside ultrasound (FAST/POCUS) and CT, use clinical findings to guide imaging, and engage paediatric radiology early for protocol selection and dose reduction (NICE NG39; IR(ME)R; RCEM).
Overarching principles
- Justify every ionising‑radiation examination and apply the ALARA principle (As Low As Reasonably Achievable).
- Comply with IR(ME)R requirements and audit local practice against national Diagnostic Reference Levels (NDRLs) (GOV.UK).
- Base imaging decisions on clinical assessment (mechanism, examination findings, physiology), not mechanism alone.
- Target the smallest scan extent that answers the clinical question; avoid default adult whole‑body trauma protocols for children.
- Early discussion with on‑call paediatric radiology is recommended for equivocal cases, choice of scan extent (targeted vs whole‑body), contrast use and dose optimisation (RCEM).
Focused Assessment with Sonography in Trauma (FAST / POCUS)
Role
- Rapid bedside adjunct during resuscitation to detect free intraperitoneal fluid and pericardial effusion/tamponade.
- Guides immediate procedures or triage decisions.