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Sedation for Radiologic Studies
This information sheet is provided to help you and your child prepare for his or her upcoming test in the Department of Pediatric Radiology at Children’s Hospital of Pittsburgh of UPMC.
Your child’s doctor has suggested that sedation may be needed for your child to successfully complete the Radiology test that has been prescribed.
Why Is Sedation Needed?
It is important that your child is comfortable and stays very still during the test so that the best possible pictures can be obtained for the most accurate evaluation and diagnosis. Sedation medication will make your child very drowsy and relaxed during the test. Your child will not feel any anything during the test or remember it afterward.
Which Type of Sedation Is Right For My Child?
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. Attached is a form that will give us your child’s basic health history, especially known allergies and current medications your child is taking. Please carefully complete this form at home and bring it with you on the day of your child’s test.
Knowing if your child has any chronic health conditions, such as gastroesophageal reflux (GERD), asthma, snoring, or sleep apnea, will help determine the type of sedation your child will need. Your thorough completion of the health history form will help our pediatric radiology doctors determine your child’s suitability for sedation medication. If the doctors decide that your child needs a different type of sedation, your child's test may need to be rescheduled for a different day.
If your child has a bad cold or congestion, or has been vomiting or having reflux, he or she may not be able to be given sedation medication. Based on your child's health history and health status on the day of the test, you will be informed by a member of the sedation services staff whether or not your child is able to have 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.
Important Instructions Before the Test
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.
- Your child should have nothing by mouth in the 2 hours before the test—not even a sip of water, gum or a mint.
- 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.
What You Must Bring To the Test
You will need to arrive at the 4th floor Radiology registration area approximately 1 hour 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;
- The registration form; and
- Your child’s completed health history form.
**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 cannot and will not be performed 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.
The Pre-Test Evaluation
A staff member will escort you to the exam room where he or she will review the health history form with you and do a brief examination of your child. The Physician’s Assistant (PA) or Certified Registered Nurse Practitioner (CRNP) will consult with the attending pediatric sedationist to decide which sedation medication your child will receive. The nurse assigned to your child will take all vital signs and insert an intravenous (IV) line if needed for sedation or contrast (a type of medicine that helps in taking the pictures). Babies under 1 year of age may receive oral medication rather than IV medication for sedation, but will need an IV if contrast is to be given.
Children ages 4 and up may be able to have the test without sedation, depending on their developmental status, the length of the test and their ability to remain still for the whole test. Most older children are able to lie still during the MRI without sedation by watching a movie or listening to music with a pair of headphones.
The MRI does not use radiation. The MRI unit is basically a very large, tube-shaped magnet through which the computer takes detailed pictures of the body. For this reason, NO metal that could come loose or fly free is permitted in the room. As for metal within the body, you and your child will be carefully evaluated to be sure that it is safe to go into the room. All gold and platinum jewelry is safe; however, watches, credit cards, cell phones, pagers and pacemakers can be damaged by the powerful magnet. Clothing with metal zippers, snaps or rivets may need to be removed if it is close enough to the magnet to cause interference with the pictures. Your child may be given a gown to change into, and there are lockers available to safely store any personal belongings during the test.
The MRI unit is not dangerous, nor is it painful, but it can be quite loud. For this reason, you and your child will both be given earplugs to wear throughout the test. If your child does not need sedation, he or she may also select either music CDs or a movie to watch with special MRI goggles and headphones, instead of ear plugs. Once in the MRI room, your child will be placed on the special table that moves. Both monitoring equipment and oxygen will be nearby for your child’s sedation. Your child will be wrapped snugly in a sheet to help keep him or her still and secured onto the unit using a large Velcro seatbelt. Depending on the test, equipment may be used to isolate the body part being scanned. For example, during an MRI of the brain, a helmet-like coil will surround the head, although it will not touch the head itself.
After the test, your child will be taken to a recovery area. One parent will be permitted in the recovery room to be with your child as the medications wear off. 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 be offered juice and crackers and will remain in the recovery unit to be monitored for a minimum of 1 hour 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 offered Mountain Dew or Pepsi to reduce the side effects of the medications and hasten his or her recovery.
The Rest of the Day
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 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 a sedation nurse the next day to check on your child as a follow up.
The images are online and available to any Children’s doctor. The pediatric radiologist’s written report should be available in approximately 48 hours. Please contact the doctor who ordered the test for your child’s results. Please understand that the staff is not permitted to evaluate or discuss any results with you. Only your referring doctor can provide the results of your child’s scan.
If your child has any special needs or health issues you feel the sedation services or Radiology staff 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.
Department of Pediatric Radiology
Children’s Hospital of Pittsburgh of UPMC
One Children’s Hospital Drive
4401 Penn Ave.
Pittsburgh, PA 15224
412-692-5500 or 412-802-6440
February 28, 2012
February 28, 2012