Sedation

  • Occasionally, children must undergo procedures that require them to remain perfectly still. To help with this, The Children’s Hospital at Memorial University Medical Center offers sedation services administered by a team that includes pediatric intensivist, anesthesiologist, nurse anesthetist, pediatric nurses, a pediatric respiratory therapist, and a child life specialist. We have organized a child friendly and family centered way to reduce the pain and stress of sedation procedures. Before any sedation procedure, we meet with the child and parents to answer any questions they may have.

    Children should not eat or drink anything for six hours before sedation. A short-lasting, fast-acting sedation is delivered through an I.V. When the child is asleep, we are able to complete the necessary medical procedure. Throughout the process, the child is monitored closely. When the procedure is over, the child recovers rapidly and can usually resume normal daily activities within an hour.

    Sedation services are available Monday through Friday for radiology procedures, hematology/oncology procedures, Botox injections, and other invasive procedures.

    Safety is our primary concern when administering sedation to young children. The following guidelines address key factors in preparing your child for procedural sedation.

    Patient Guidelines

    Acute illness -- If your child is acutely ill, he/she should not be sedated. If your child develops a cough, cold, fever, congestion, vomiting, wheezing, or diarrhea two days before his/her scheduled procedure/test, your appointment should be rescheduled. Please contact the pediatric sedation team at 912-350-7460 to reschedule the appointment.

    Eating and drinking guidelines -- When patients receive sedation/anesthesia, their bodies and digestive system relax. If there is any food or liquid in the stomach, patients are at risk for vomiting, which could get into the lungs and cause a life-threatening situation. In order to sedate your child safely, it is very important that you follow the rules for fasting provided to you by the pediatric sedation team. These guidelines will be sent to you in the mail when your child has been scheduled for his/her appointment. If you have any questions, call 912-350-7460.

    Routine medications -- In general, medicines can be taken as scheduled with a small sip of water. However, a nurse will go over the medications with you and answer any questions that you may have one to two days before the child’s scheduled appointment.

    What to Expect Before Your Procedure

    A member of our pediatric sedation team will contact a parent/guardian one to two days before the child’s scheduled appointment. The sedation team member will obtain an assessment that will include the reason for the procedure, medical history, previous surgeries and problems with anesthesia, medications presently taken, allergies, and your child’s current health. You will also be asked to share information about any previous experiences your child has had with tests or procedures, and how well he/she coped with the experience.

    The sedation team member will talk with you about the rules and guidelines for eating and drinking that have been established for your child. Every child is different depending on his/her medical history. These guidelines must be followed closely for the safety of your child.

    You will be given information about your test or procedure and will be able to ask any questions that you may have.

    What to Expect the Day of the Procedure

    Upon your child’s admission, the sedation team will confirm your child’s name and date of birth and ask about the last thing the child ate or drank. You will also be asked to confirm the procedure your child is scheduled to receive. The sedation process as well as procedural process will be explained to you and you will be given the opportunity to ask questions. You will then be asked to sign consent forms. Your child’s weight will be checked, vitals obtained, and health history reviewed. An I.V. for medications will be placed in the best obtainable spot for your child. It is important to remember our goal is to make this as stress free as possible for you and your child. To that end, it can be helpful if parents do not make a big deal about the I.V. or make comments about it being a needle. When you appear calm and relaxed during the I.V. insertion, your child will relax too.

    After an I.V. has been placed, the physician or anesthesiologist/nurse anesthetist will assess your child and answer any questions or concerns that you may have.

    One parent will be allowed to stay with the child until he/she falls asleep. When the child is asleep, we ask that all parents wait in the waiting room. During the procedure, the physician or nurse anesthetist and another nurse or respiratory therapist will stay with your child. Your child will be hooked up to monitors and wear an oxygen mask during the procedure.

    After the procedure, your child will move to the recovery bed and will be monitored until fully awake. You will be allowed to be at the bedside at this time. We will ensure that your child is kept safe and comfortable during this time.

    Before your child is discharged, instructions will be given regarding what behavior to expect from your child, resuming regular activities, how to obtain the results from your child’s test or procedure, and who to call if you have questions related to the sedation your child received.

    What to Expect After Sedation/Anesthesia

    Generally, children tolerate the type of sedation we provide very well. It is rare that a child vomits afterward, although it could happen. Your child may not have his/her usual state of alertness and coordination for several hours after sedation/anesthesia. Although young children may be persistent in wanting to walk, it is unsafe for them to do so for several hours after the procedure.

    You should avoid letting your child do anything that may require coordination or quick response the rest of the day. Please do not let your child return to school or daycare on this day as he/she will need to rest following the procedure. The following activities should be also avoided:

    • Walking up or down stairs
    • Riding a bike, skateboard, ATV, etc.
    • Swimming
    • Running
    • Playing Ball
    • Driving a car (for teenagers)

    If You Have Questions

    The pediatric sedation team is available to answer any questions you may have about your child’s procedure. Please do not hesitate to contact us at 912-350-7460.

    Information for Physicians' Offices

    To schedule a pediatric patient for procedural sedation, call central scheduling at 912-350-2766. Please be prepared to provide the following information about the patient:

    • Demographic information
    • Current insurance information
    • Written and signed physician order that includes patient name, date of birth, procedure/exam name, diagnosis, and any special instructions
    • Most recent history and physical from the referring physician's office (required to help us recognize any potential sedation risk factors or other considerations)

    The pediatric sedation team will contact your office with the appointment date, check-in time, and fasting instructions for the procedure.

    Our pediatric sedation team typically starts an I.V. on every patient. All medications are given through this access line. Parents can stay with their child and comfort them through this process.

    Our guidelines state that every child must be at least six hours NPO with light meals. We do give smaller children consideration regarding clears. The child’s health history and previous sedation history are taken into account when determining the NPO status. The NPO guidelines must be followed for the safety of the child.

    If a child is sick or begins experiencing cold symptoms before the procedure, the parent or guardian should contact the pediatric sedation team at 912-350-7460 to discuss the child’s current health status. In general, if the child is acutely ill, he/she should not be sedated. If the child develops a cough, cold, fever, congestion, vomiting, wheezing, or diarrhea two days before the scheduled sedation, the procedure/test will most likely be rescheduled.

    On the day of the procedure, one parent will be allowed to stay with the child until the child falls asleep. During the procedure, the parents will wait in the waiting room. The child will be cared for by a physician or CRNA and a nurse or respiratory therapist. The child will wear an oxygen mask and his/her vitals will be monitored during the entire procedure. After the procedure, all test results will be sent to the referring physician's office along with special instructions, when necessary.

    We ask that physicians refrain from adding to an exam/procedure after the appointment has been scheduled. Each patient is given a time allotment based upon the specific procedure. Adding another procedure impacts the sedation schedule for other patients and providers.