Children undergo scans without anaesthesia
With the help of a little brown troll named Rumle, an interactive app, and a child-friendly scanning environment, even very young children can now undergo MRI scans without requiring anaesthesia.
Imagine lying on a hard table, slowly being slid into a circular tube. You need to stay completely still for almost an hour while a machine, as loud as an aeroplane engine, scans your body. Sounds tough, doesn’t it? Now imagine you’re only four years old and facing the same experience.
At Lillebælt Hospital in Kolding, this challenge has been transformed. During the scan, children can choose their favourite film and music to enjoy in a familiar setting they’ve already explored at home through an app.
– We cannot remove the noise of the scanner, but we can prepare children so effectively that anaesthesia is no longer needed. This has reduced waiting times for children’s MRI scans, as anaesthesia is no longer required. Moreover, our research confirms that the images we produce are of such high quality that they are fully reliable for diagnostic purposes, explains Helle Precht, Associate Professor at the Department of Regional Health Research and Sygehus Lillebælt.
In the past, anaesthesia was standard practice for children undergoing MRI scans, as their ability to remain completely still was crucial for capturing clear images. Today, more than 95% of scans are successfully completed without anaesthesia.
Preparing at home
A little brown troll named Rumle, along with an interactive app, helps children feel prepared and confident about the scanning process. At home, they can watch a short, animated film that walks them through the entire experience—from entering the radiology department to completing the scan. They can also explore videos, listen to music, and meet Rumle’s friends.
Through the app, children actively participate by guiding a virtual child through the scanning process. For example, they can help remove items like watches and shoes, accompany the child to the scanner, and even assist the virtual child in staying still by holding a finger on the screen.
It is not just the children who are well-prepared — staff are equally equipped. The paediatrics department ensures that hospital personnel receive training to keep their communication skills with children up to date.
Familiar environments foster comfort
The radiology and scanning department follow the Children Centred Care approach, which focuses on four key elements: an interactive app, a dedicated children’s team, a children’s lounge with a model MR scanner, and a child-friendly scanner room featuring familiar images, films, and sounds. This entire experience takes place within a universe that children already know from the app.
3 tips for effective communication with children in hospitals
Position yourself at the child’s eye level.
Adapt your language and explanations to suit the child’s age and understanding.
Show genuine interest in the child’s hobbies and interests beyond the hospital setting.
When children arrive at the hospital for their examination, they are guided by butterflies and Rumle to the children’s lounge in the radiology department. Here, they are welcomed by staff specially trained to communicate effectively with children, ensuring a positive and reassuring experience.
Before the scan, children have the opportunity to explore how an MRI scanner works. They can even use a miniature scanner to examine Rumle’s friends. Once Rumle’s friends have been “diagnosed,” it’s time for the child’s own scan. By this point, most children are already well-prepared and know what to expect — for instance, they’re aware that shoes need to be removed before entering the scanner.
When the child steps into the scanner room, their chosen film and audio are ready and waiting. They also get to decide where their mum or dad should stand, as parents are always present in the room to provide comfort and reassurance. After the scan, the child is rewarded with both a gift and a diploma to take home - a positive ending to the experience.
Reassured parents and children
A recent study conducted by the radiology department explored the impact of the Children Centred Care approach on young patients.
Researchers used an online questionnaire to gather feedback from parents and children about their experiences with the scanning process. The children were divided into two groups: one group was prepared using the Children Centred Care approach, while the control group followed the standard preparation method.
– The study showed that the Children Centred Care approach was significantly better than our traditional method. It provided a more comfortable experience for the children, while parents felt well-prepared and reassured. At the same time, our skilled clinical staff enjoy this approach because they can see the meaningful difference it makes for our young patients, explains Helle Precht.
– It’s an incredibly fulfilling way to work because we can clearly see the positive impact. The number of children who find hospital visits unpleasant - for instance, during blood tests - is steadily decreasing. We are seeing fewer and fewer children having traumatic experiences with the healthcare system, says Thomas Houmann Petersen, Chief Physician at the Paediatrics Department, Kolding Hospital.
The Paediatrics Department hopes to further develop the concept, with the goal of applying it to other procedures, such as IV insertions and lumbar punctures, where spinal fluid is collected using a needle.
Rumle and the child-friendly hospital project
In 2011, the Paediatrics Department at Kolding Hospital came up with an ambitious idea: to create the ideal framework for a child- and youth-friendly hospital. The vision included a cohesive and recognisable universe combined with training staff to communicate effectively with children.
During a renovation of the Paediatrics Department, the team seized the opportunity to make the environment more welcoming for children. The department’s decorations play a key role in this effort, with the same design elements featured throughout the hospital in areas where children receive care. At the heart of this child-friendly universe is Rumle, a lovable brown troll who has become a central figure in the hospital’s approach to easing children’s experiences.
This concept has now extended beyond the Paediatrics Department to the radiology and scanning department, where even very young children - as young as four years old - can successfully undergo MRI scans without anaesthesia. This is a procedure that requires children to remain completely still for up to an hour. MRI scans are commonly used to diagnose conditions such as cancer, as well as diseases affecting the heart and brain.
The Paediatrics Department also shares its expertise in child communication with staff in other departments, ensuring that both children and their parents feel fully prepared for upcoming procedures.
With the support of a dedicated app, children and their parents can familiarise themselves with the MRI scanning process before arriving at the hospital. A similar app is also available to help children understand what to expect during blood tests.
Over the years, this project has been further refined by a larger project group, developed in collaboration with partners such as the Health Innovation Centre of Southern Denmark.
Meet one of the researchers on the team
Helle Precht is a radiographer, associate professor, and coordinating head of research at IRS Lilleb忙lt Hospital.