Sedation for Radiologic Studies

Different children may need different types of sedation depending on their individual health conditions, so it is important for us to have an accurate medical history for your child.

Our Sedation team will review medical information obtained from the referring service, electronic health record and from discussion with caregivers. Knowing if your child has any chronic health conditions, including but not limited to conditions such as gastroesophageal reflux (GERD), asthma, snoring, or sleep apnea,will help determine the type of sedation your child will need.

Your assistance in compiling a health history will help our sedation radiology doctors determine your child's suitability for sedation medication. Radiology tests themselves are generally not harmful. But sedation medication, like any medication, can have serious risks — such as cardiac or respiratory arrest — that are not to be taken lightly. Therefore, it is critical that we have an accurate and current health history on your child.

If your child has any special needs or health issues you feel the doctor performing the scan needs to know about, please call the Department of Pediatric Radiology at Children’s before the test and ask to speak with a nurse. It is important to notify us in advance about any special needs.

Preparing your child beforehand, as well as comforting your child during the test, will help your child have a more positive experience. Sometimes it is difficult to know how to explain tests to children. If you have any questions about ways to prepare or support your child, or if feel your child will have difficulty during the test, please call the Department of Pediatric Radiology at Children’s and ask to speak with the Child Life Specialist.

One or two days before your child's appointment, you should receive a phone call from one of the sedation nurses to go over details of the test day with you. If you do not receive a call, you may call 412-692-9524, from 7 a.m. - 8 p.m., to speak with a nurse. He or she will review the instructions with you.

The night before the test, your child may have a normal dinner. What your child eats and drinks in the hours before the test is based upon the time of day the test is scheduled.

• Your child should have no solid foods or milk products in the 8 hours before the time he or she is scheduled to have the test.
• If your child is on formula, he or she may have formula up to 6 hours before the test.
• If your child is nursing, he or she may have breast milk up to 4 hours before the test.
• Your child may have clear liquids (water, apple juice, clear Gatorade, or Pedialyte ONLY) up to 2 hours before the test.Your child should not drink any carbonated beverages,such as soda pop or sparkling water, in the 2 hours before the test.
• Please stop all liquids 2 hours prior to arrival time.
• It is important to keep your child from becoming dehydrated. Before the 2-hour limit, give your child clear liquids in the morning before the test. If you have an early appointment, you may want to awaken your child earlier than normal to give your child fluids and then allow him or her to go back to sleep.

Please alert our staff if your child has a metabolic disorder that requires special handling.

You will need to arrive at the Radiology registration area approximately 1 -2 hours before your scheduled appointment to be registered for the test. Please bring the following items with you:

• The doctor's prescription for the test;
• Your child's medical insurance card;

**Special note: If you are not the birth parent or legally adoptive parent, (such as a step-parent, foster parent or legal guardian) you must bring proof of your legal right to grant permission for medical care and treatment for the child — specifically, an order signed by a Judge. The test may be delayed or cancelled if this legal paperwork is inadequate or missing. You should be able to obtain this paperwork from your caseworker, adoption agency and/or attorney without any problem.

Prior to an exam with sedation you will see many staff members that include a PCT, RN and Physician's Assistant (PA) or Certified Registered Nurse Practitioner (CRNP) who will all consult with the attending pediatric sedationist to decide which sedation medication your child will receive. The nurse assigned to your child will insert an intravenous (IV) line if needed for sedation or contrast (a type of medicine that helps in taking the pictures).

Some children may be able to have the test without sedation, depending on:

• Age.
• Body size.
• Developmental status.
• The length of the test.
• Their ability to remain still for a determined amount of time.

We have Certified Child Life Specialists to assist us in determining if a form of distraction may be used either in place of or in conjunction with a form of sedation.

If the exam is an MRI, we also have movie goggles available in most instances. Please ask when you are scheduling the exam.

After the test, depending on the type of sedation, your child may be taken to a recovery area.The length of time it takes the medications to wear off will vary, as some children take longer than others to become alert.

Your child will remain in the recovery unit to be monitored to be sure he or she is not having any problems from the sedation and is able to eat and drink. Once your child is taking fluids and is alert, the IV will be removed, and he or she will be discharged.

Some children may have adverse reactions to the medications and could awaken very cranky and difficult to manage. If that happens, your child will be managed to reduce the side effects of the medications and hasten his or her recovery

If your child received sedation medication, you can expect your child to be a little wobbly and tired or cranky the rest of the day. Your child should avoid activities such as playing on playground equipment, swimming, bike riding, jumping on trampolines or other physical activities requiring intact motor skills.

You probably will not want him or her to return to school, after-school activities or sports practices, or daycare for the rest of that day. His or her diet should be kept light for a few hours after the test. Avoid fatty and fried foods.

After about 24 hours, the sedation effects should have completely worn off. If your child should have trouble with nausea or vomiting or remains lethargic or wobbly past 24 hours, please contact your doctor. You will receive a call from the sedation team the next day to check on your child as a follow up.