Many of the tests and procedures we perform in the Radiology Department require that children hold still in a particular position anywhere from a few minutes to several hours. Sedation is used as a tool to aid children in meeting these requirements so that the images obtained are the best quality possible. Sedation in combination with pain medication is also used in the Radiology Department to help children remain comfortable during stressful procedures.
Several factors are considered when determining if your child will need sedation: the age and developmental level of your child, the length of time it takes to do the test or procedure, and the amount of discomfort expected during the test/procedure. The radiology scheduler uses this information as a guideline for scheduling your child in a "sedation slot." The physician/practitioner who ordered your test may also request that your child have his/her test scheduled with sedation. Please let the radiology scheduler know if you have concerns that your child may need sedation but is not scheduled to receive sedation.
The exact medications used for sedation vary depending on your child's age, weight, developmental level, health history, physical exam, and type of test/procedure being done. A Sedation Nurse Practitioner/Physician will evaluate your child prior to the test or procedure and discuss the sedation plan with you, including side effects, risks, and options.
The Radiology Department follows the hospital's pre-anesthesia guidelines for eating and drinking. It is very important that you follow these instructions or your child's test may be delayed or rescheduled. Some tests require a special oral prep the night before the test. Please follow the diet/prep instructions you are given for your child's particular test. If in doubt, call the Radiology Department Phone Triage Nurse at (215) 590-0694.
No food, milk, drink, candy or gum after 11 p.m. the evening before the procedure, except:
Consoling a young child who is not allowed to eat is a challenge. Be vigilant that the child does not help himself to food or drink and keep him away from other children who are eating. A hungry child is very resourceful at finding things to eat (example: pieces of cereal under the car seat cushion), and a sympathetic brother or sister may be tempted to share food.
Your child will need your full attention the day of the procedure. The entire process, from arrival through sedation and recovery, can be physically draining for any parent/caregiver. For your own well-being, we strongly encourage you to eat and drink prior to arrival. We do not allow food or eating in the radiology waiting rooms or patient care areas. If you need to step out of your child's room for a snack or a drink, please ask your nurse for assistance.
Unless otherwise instructed, you may give your child his/her morning prescription medications while he/she is still allowed to take clear liquids. Remember — DO NOT give your child medication with applesauce or pudding, as these are considered solid foods. You may use Jell-O as an alternative to applesauce or pudding. Medications that are due later in the day may be given after your child has completed the test/procedure and recovered from sedation. Please give your child his/her usual respiratory medication treatments the night before and morning of the test.
Children who are scheduled to receive sedation should arrive one hour before the test/procedure is scheduled. You will receive a phone call with a specific arrival time from our phone triage nurse. Once you arrive, the first thing that you need to do is register your child for his/her test. The registration area for Magnetic Resonance Imaging (MRI) scans is located near the bank of elevators on the 2nd floor of the Wood Building. All other radiology patients are registered in Outpatient Registration located on the 3rd floor of the Main Building (accessible through the Wood Building), near the large stairway that leads to the main atrium.
For general directions, or specific driving directions to the Main Building, visit our Directions/Parking site.
It is vitally important that you arrive promptly and allow ample time for traffic and construction, especially if the area is unfamiliar to you. Late arrivals may need to be rescheduled; kindly notify us if you are delayed and we will advise you. Parking is available in the Wood Building garage.
A member of the radiology staff will escort you and your child to a patient care area where your child will be prepared for sedation. A nurse or medical technician will weigh your child and obtain a set of vital signs (temperature, heart rate, breathing rate, blood pressure, and oxygen reading). You will be asked questions about your child's last solid food and clear liquid intake, allergies, current pain issues, and recent medications. A Sedation Nurse Practitioner/Physician will ask you several questions about your child's health history and will do a brief physical exam. The sedation plan will be discussed with you, including side effects, risks, and options. You are encouraged to ask questions and discuss any concerns you have about the plan. Your child will be given age appropriate information and the radiology staff will make sure that your child completes any further preparations needed for his/her particular test.
Please go to the Kids Health Galaxy website for a video designed to prepare your child for IV placement. The Child Life and Education website contains additional information about helping your child cope. For more details about your child's test and what to expect, visit our diagnostic imaging procedures page. We have additional resources available designed to help you prepare for your visit to radiology.
A Registered Nurse who specializes in sedation will give your child the sedation medication(s) and monitor your child's heart rate, breathing, blood pressure, and oxygen level during the test/procedure. Many children receive oxygen or special airway positioning because they breathe shallow, slow, or even snore during sedation. Some children need help breathing during the start of sedation. The Sedation Nurse Practitioner/Physician is available to help your child breathe. Once your child's test or procedure is completed, he/she will return to the patient care area for recovery.
On rare occasion, a child may "fail sedation". This means that the child was not able to complete the test or procedure because the desired depth of sleep was not achieved, or the child did not tolerate sedation and the test or procedure had to be stopped before it was finished. The physician who ordered the test/procedure will be notified and given the option of rescheduling the test for a later date with general anesthesia. The parent or guardian will be given specific information about the failed sedation and a nurse practitioner will complete the child's pre-anesthesia evaluation record.
The expected recovery time varies from one to several hours. It is influenced by the amount and type of sedation your child was given and by factors that are specific for your child: how fast the medication is used up and your child's usual sleep patterns (is this nap time?).
During recovery, your child will continue to be monitored and you will be asked to stay at your child's bedside. You will be instructed NOT to wake your child for at least an hour after returning to the recovery area. Children tend to wake up cranky and miserable if they wake from sleep too soon.
Approximately 5% of children will wake up with "emergence delirium". They appear to be awake, but are not really aware. During this time, the child may cry, thrash, and reach for the parent. Nothing seems to calm the child. It is upsetting to watch but usually goes away by itself. Your nurse will make sure that your child is safe. Sometimes, a quiet, dark room can help the child go back to sleep. Usually, it just takes time for the effects of sedation to wear off. Try to stay calm, speak softly, and comfort your child. He/she will not remember this excited state and often, will wake up feeling fine.
Once your child is awake and able, he/she may gradually resume feeding. Infants may receive their usual formula or breast-feeding, and older children may receive juice and cookies or crackers prior to going home. Children on special diets or tube feedings may resume their routine as tolerated. Sedation may cause nausea and vomiting so you are encouraged to avoid foods high in fat or protein until your child is completely back to normal. We also suggest that you avoid feeding your child on the car ride home. If your child has nausea or vomiting prior to discharge, intravenous (IV) fluids and medication may be given to help your child feel better. If your child has nausea or vomiting after leaving the hospital, call the phone number listed on your discharge instructions and the sedation staff will advise you.
Unless otherwise instructed, your child's home medication routine may be resumed. Children who are being admitted to the hospital following their test/procedure will have a diet plan and medications ordered once they are on the inpatient unit.
It is very common for children to be wobbly and prone to falls for up to 24 hours after sedation, so activities that require coordination should be restricted. Infants and young children need extra head support when being held and children who are able to walk will need assistance from an adult to keep them from stumbling into the furniture or falling down stairs. Quiet activities are recommended at home until the child is back to normal. Children are generally able to return to school 24 hours following sedation. The sedation staff will be able to give your child a note for school and advise you if you have any specific questions or concerns.
You will be given written discharge instructions before you leave the hospital. The instruction sheet will give you the phone numbers that you may call if you have a question or problem at home. The Radiology Phone Triage Nurse will also call you the next day to see how your child is doing and ask about his/her sedation experience.