Procedural Sedation In Children

  • Reference Number: HEY-826/2016
  • Departments: Emergency Department

Introduction

This leaflet has been produced to give you general information about your child’s treatment.  Most of your questions should be answered by this leaflet.  It is not intended to replace the discussion between you and your doctor, but may act as a starting point for discussion.   If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for your child.

Why does my child need sedation?

Some tests or treatments can cause pain or distress, especially to children. Sedation aims to reduce your child’s pain and anxiety. The sedation may make your child feel sleepy and relaxed, meaning the procedure can be performed more easily and with less distress for your child and you. Your child may not remember the procedure at all or only remember small amounts. This is normal.

What does sedation involve?

During sedation your child will be cared for by a doctor and a nurse. They will be given oxygen through a face mask and will be monitored closely. Most types of sedation require an injection into a vein. Your child may become very sleepy or they may seem to stay awake. They may become disorientated or confused. Occasionally children vomit with sedation. Rarely there may be problems with their breathing, which very occasionally (0.02%) means that your child may need to be given a general anaesthetic with a breathing tube placed in their windpipe.

If your child is given a medication called Ketamine, which is commonly used in hospitals for sedation in children, please be aware that:

  • Your child may move a little without obvious cause. This is normal.
  • Your child’s eyes may twitch. This is normal.
  • Your child may report odd dreams on waking up and may become a little agitated (less than 20% of children experience this). This tends to improve if you comfort your child in a quiet area until they are awake fully.
  • One in ten children develop a rash.
  • One in ten children will have some eye watering or may drool.
  • One in twenty children have some twitching movements.
  • Rarely (0.3%) there can be laryngospasm (vocal cords close).

How can I help my child?

Before the procedure

  • Ask the doctor/nurse to explain the procedure to your child and you. If you do not understand please tell us.
  • Talk to your child about some ways to cope (for example – looking at a book, blowing bubbles, talking about something nice).
  • Try not to be too upset or nervous as your child will notice this.

During the procedure

  • A parent (or another adult who knows your child) may stay with them as this can be helpful.
  • Depending on how deeply sedated your child becomes they may need reminders of the coping methods you decided on earlier.
  • It is not helpful to allow your child to decide the exact moment the procedure is going to happen.

After the procedure

  • Remain with your child. They may not remember where they are or why they are in hospital.
  • Focus on the good things your child did.

After you go home

Sometimes the delayed effects of the medicines may make your child confused, sleepy or clumsy. You need to be extra careful in caring for and supervising your child for the next 24 hours.

  • Most children recover within 90 minutes. Your child will be safe to go home when they are awake fully, can walk unaided and manage to drink without vomiting. Once they are home they should be supervised closely for the first 8 hours and avoid strenuous play or sporting activity for 24 hours.
  • Supervise all playing and bathing for the next 8 hours after getting home. DO NOT let your child swim or use play equipment (bikes, monkey bars, etc.) that might cause an accident for the next 24 hours.
  • Sometimes children may feel sick or vomit if they eat a big meal too soon after sedation. Give your child small amounts of clear fluid such as diluted fruit juice, ice lollies, jelly, clear soup, etc. and wait 2 hours before giving them a meal.
  • Let your child sleep. Sometimes children sleep more because of the sedation medicine. This is normal.

If you have any concerns that your child may be experiencing problems relating to the sedation that they have received, please contact the Paediatric Emergency Department on telephone number (01482) 482108 [8.30am-2am], or (01482) 482251 [2am-8.30am].

Your child’s procedure

The sedation your child received was:

 

 

The procedure performed was:

 

 

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats your child, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to your child. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your child’s condition, the alternatives available for your child, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

  • you must be able to give your consent
  • you must be given enough information to enable you to make a decision
  • you must be acting under your own free will and not under the strong influence of another person

Information about your child

We collect and use your child’s information to provide your child with care and treatment. As part of your child’s care, information about your child will be shared between members of a healthcare team, some of whom you may not meet. Your child’s information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide your child with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your child’s doctor, or the person caring for your child.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about your child. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.