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Many tests and procedures require that children hold still in a particular position for anywhere from a few minutes to several hours. Sedation is the use of a sedative or tranquilizing drug to help children relax. It can help minimize your child’s fears and anxiety during a test or procedure.
Sedation, in combination with pain medication, is also used to help children remain comfortable during painful procedures.
There are several levels of sedation:
Sedation medications can be given:
At The Children’s Hospital of Philadelphia, we provide inpatient and outpatient sedation for infants, children and adolescents in the Pediatric Sedation Unit.
Our staff of highly trained pediatricians, nurse practitioners, nurses and child life specialists works very closely with your child and family to determine the most appropriate sedation plan.
We use multiple methods to help children tolerate their procedures, including distraction, preparation, and teaching techniques followed by sedating medications. Medications and levels of sedation are chosen based on your child’s needs and developmental level, duration of the test or procedure and invasiveness of the procedure.
Some of the medications used for pediatric sedation include:
If your child needs a test or procedure that requires her to sit or lay still for a few minutes or several hours, she may need pediatric sedation. Sedation helps your child remain calm and relaxed, and can assist us in getting the most accurate results possible.
Preparing your child for sedation depends on what works best for your child and family. For some children, telling them too far in advance of the procedure or test may actually increase their anxiety. In this case, the best way to help prepare them is brief, factual information the morning of the procedure, or the day before the procedure.
Other children may need more time — a few days to a week — to process information, ask questions and get help working through coping strategies.
If your child has special needs, please tell the Sedation Unit scheduler so we can connect you with any additional resources that may be helpful and plan the best ways to work with your child.
Sedation requires fasting before the procedure. Our triage nurse will call you the evening before your child's test or procedure to give you specific information about fasting.
The following are some general guidelines:
To make sedation as easy as possible for you and your child, please bring anything you think will be comforting or entertaining during expected wait times. In addition, please remember to bring any communication systems your child may have. Our staff also wants to know of any ways we can support you and your child, so please tell us about your child’s likes and dislikes, concerns and needs.
Some suggestions that have worked for other patients and families:
A typical visit to CHOP’s Pediatric Sedation Unit lasts a minimum of three to four hours. This includes registration, the procedure and recovery.
Please arrive 1½ hours (90 minutes) before your child’s scheduled procedure. Our team needs this time to:
Most procedures last approximately 30 to 60 minutes. Interventional radiology procedures average one hour, and MRIs last approximately one hour per study ordered. Your nurse will be able to provide a time frame for you depending on your child's procedure.
Recovery will also last approximately one hour. However, each child is different, and some children wake earlier while others require longer recovery times.
We suggest siblings stay at home to minimize distraction. If this is not possible, please bring toys, coloring books and favorite snacks to keep children entertained. There is a cafeteria available; however, fragrant foods are discouraged on the unit as patients are fasting.
After registration, one of CHOP’s medical assistants will guide you and your child to an assigned Sedation Unit room. This staff member will measure your child’s weight and vital signs (heart rate, blood pressure, oxygen saturation and temperature).
A registered nurse (RN) will join you and will go over the sedation process with you. A nurse practitioner and/or physician will examine your child before sedation begins. They will also ask for your written consent for the procedure.
Sometimes, a Child Life Specialist will help prepare your child for his medical procedure by using age-appropriate education and supportive activities. A Child Life Specialist is a professional trained to speak with children about the procedure from CHOP’s Child Life, Education, and Creative Arts Therapy department.
Your child may receive an oral medication, which begins the sedation process. Then, an intravenous catheter (IV) will be placed and secured in your child’s arm to give her fluids and the rest of the sedation medicine.
As your child is going to sleep, a calm approach on your part is best. Less stimulation in the room usually results in the need for less medication.
While your child’s study or procedure is underway, you may stay in the Sedation Unit or leave the unit to use the restroom, visit the cafeteria or check in with a clinic.
Most procedures last approximately 30 to 60 minutes. Your nurse will be able to provide a time frame for you. The nurse will also ask for your cell phone number, if you have one, so that you may be updated with times as needed.
Once the procedure or diagnostic study is completed, your child will recover in his original Sedation Unit room. Recovery time is variable, but averages about 45 minutes to one hour. Your child will receive fluids through his IV to help with recovery.
Children who wake prematurely are at risk for “emergence delirium,” where they appear awake but are extremely upset and can injure themselves. This may last for several hours. For this reason, you may be asked to minimize interacting with your child to allow him to awaken slowly.
Some children can become sick to their stomach after sedation and may require medication through the IV to prevent nausea and vomiting. The IV will be removed before your child goes home.
Once your child is ready to leave, the nurse will give you instructions on how to care for your child at home. The nurse will also give you a number to call for any questions or concerns that arise after you go home.
If your child with special needs has a very rigid daily routine and needs pediatric sedation for a procedure or test, please tell the Sedation Unit scheduler.
We may be able to provide:
Sedation is the use of a sedative or tranquilizing drug to help your child relax. It can help minimize your child’s fears and anxiety. Sedation, in combination with pain medication, is also used to help children remain comfortable during painful procedures.
If your child has significant challenges in the hospital setting or other similar settings, we encourage you to let the nurse know when she calls to complete your child’s intake process or when she calls with final instructions the day before your child’s procedure. Our team can use this information to better prepare for your visit and to connect your family with a Child Life Specialist prior to the hospital visit if you are interested.
We also encourage you to share your child’s strengths and challenges with care providers during the visit, as well as the best ways to approach and work with your child.
Here are a few ideas about items you may bring from home to help your child with his hospital experience:
If you're the parent or guardian of a child with special needs, please let us know what will help your child feel most comfortable during your time at CHOP.
Please take a moment to review the following questions and we will do our best to accommodate your child’s needs.