title: Dream Doctor Intervention Instead of Sedation: Performing Radionuclide Scanning Without Sedation in Young Children: A Study in 142 Patients.
abstract: BACKGROUND
  Dream Doctors (DDs; professional medical clowns) are expanding their activities in pediatric wards. DDs were introduced as an alternative to sedation among children undergoing kidney imaging after urinary infection. The imaging requires that the patient lie completely still under the camera during the scan; otherwise the image cannot be interpreted. It is extremely difficult to get these children to cooperate, and pediatricians have to provide sedation to get good results. Giving sedation requires medical observation, and it can take hours until the child can be safely released from the hospital.
  
  
  METHODS
  A DD intervention was introduced in an attempt to avoid sedation in these young children. The DD tried to gain the child's cooperation during the procedure. Each study was subsequently scored by a radionuclide physician to assess study quality and interpretation.
  
  
  RESULTS
  A total of 142 patients were studied over a 14-month period. The mean age was 2 ± 1.6 years. During the study, in the presence of the DD, only five (3.2%) patients required pharmacologic sedation compared with 100% before the study.
  
  
  CONCLUSIONS
  The introduction of DDs proved to be a good alternative to sedation in cases where the procedure does not involve pain and only requires the child's cooperation.
authors.affiliation: 1 Dream Doctors, Emek Medical Center , Afula, Israel .
authors.forename: Avital
authors.initials: A
authors.lastname: Dvory
authors.affiliation: 1 Dream Doctors, Emek Medical Center , Afula, Israel .
authors.forename: Yaron
authors.initials: Y
authors.lastname: Goshen
authors.affiliation: 2 Pediatric Department B, Emek Medical Center , Afula, Israel .
authors.forename: Shoshana
authors.initials: S
authors.lastname: Ruimi
authors.affiliation: 3 Radionuclide Imaging Department, Emek Medical Center , Afula, Israel .
authors.forename: Sergei
authors.initials: S
authors.lastname: Bikov
authors.affiliation: 2 Pediatric Department B, Emek Medical Center , Afula, Israel .|4 Pediatric Nephrology Unit, Emek Medical Center , Afula, Israel .
authors.forename: Raphael
authors.initials: R
authors.lastname: Halevy
authors.affiliation: 2 Pediatric Department B, Emek Medical Center , Afula, Israel .|5 The Ruth and Baruch Rappaport School of Medicine , Technion, Haifa, Israel .
authors.forename: Ariel
authors.initials: A
authors.lastname: Koren
mesh_terms: D002675:Child, Preschool; D015331:Cohort Studies; D000529:Complementary Therapies / Q000379:methods*; D016292:Procedural Sedation; D006801:Humans; D007223:Infant; D011877:Radionuclide Imaging / Q000379:methods*