Other immobilization devices

Different institutions use a variety of devices to immobilize children to ensure that the radiation beam is directed with precision. These are also used on adults who receive radiation. Some of the products used are custom-made plaster of Paris casts, thermal plastic devices, vacuum-molded thermoplastics, and polyurethane foam forms. Custom-fitting the forms on a child who has already undergone numerous painful procedures requires skill and patience. Immobilization devices can be fitted on well prepared, calm, or sedated children. The following are suggestions from parents about how to prepare a child for the fitting of her immobilization device:

• Give the child a tour of the room where the fitting will take place.

• Explain in clear language each step in the process.

• Be honest in describing any discomfort the child may experience.

• For small children, fit the device onto a mannequin or stuffed animal to demonstrate the process.

• For older children or teenagers, show a video or read a booklet describing the procedure.

Seventeen-month-old Rachel was fitted with two immobilization devices. They made a mask to hold her head in position, as well as a body mold from her neck to her thighs.

The more time spent on preparation, the less time will be spent on fitting a device. If the fitting goes well, it establishes trust and good feelings that will help make the actual radiation treatments proceed smoothly.

After relapsing while on treatment, Stephan (7 years old) needed cranial and spinal radiation. I took him on a tour and explained in detail what would happen. All of his questions were answered. He would go in, have the black marks put on, and lie face down on a bed. There was a thing for his forehead to rest on, but he didn't require any other supports. He would just hold perfectly still. We kept a bucket next to the bed, because he was on high dose ARA-C, and after his radiation session, he would often need to lean over and vomit.

He was so wonderful about it. He would go up to all of the older patients who were awaiting treatment and chat. He really reached out to them, and their eyes would just sparkle.

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