Pediatric Sedation Program Reduces Anxiety Before Procedures
For more than 20 years, the Pediatric Sedation program at UW Health’s American Family Children’s Hospital has been helping alleviate both pain and fear by focusing on each child’s individual needs prior to each medical procedure.
Created by medical director Gregory Hollman, MD, a pediatric critical care physician, the program offers sedations that take into account the type of procedure that will be performed, the age, developmental status, and personality type of the child. Thought is always given to how a procedure could be accomplished without medication, through the use of preparation and/or distraction techniques, or using oral medications and avoiding an intravenous line.
“Our sedation program has been incredibly well-received by literally thousands of patients and families,” says Dr. Hollman. “Parents never want to see their child in distress and, thanks to this program, most children never even remember having the procedure in the first place.”
Typical procedures for which children are sedated include:
- Non-painful procedures that require a child to hold still for a relatively long period of time, such as MRI and CT scans
- Painful procedures such as lumbar punctures, bone marrow aspirates and biopsies and dermatologic procedures
- Distressful procedures such as voiding cystourethrograms and urinary catheter placements
How do we decide if it is safe to sedate a child?
We will review a child’s history and do a careful physical examination. We may reschedule the child’s sedation or refer them for general anesthesia if they are acutely ill or have a cardiorespiratory or other illness that places them at high risk for sedation. We may also choose to send a child through general anesthesia if they have a history of a medical condition that may compromise cardiorespiratory function, such as:
- Sleep apnea or central apnea
- Craniofacial abnormalities that distort the airway
- Poorly controlled seizures
- Severe gastric reflux disease
- Increased intracranial pressure
What types of sedation are offered?
- Minimal: The child may stay awake but be more relaxed and less aware of the procedure.
- Moderate: The child may be awake but very relaxed with little or no pain or may fall asleep but be easy to awaken.
- Deep: The child will fall asleep, have little to no movement, and will not be easy to awaken.
Our Sedation Program does not use breathing tubes. Rather, our goal is to alleviate pain and fear but, at the same time, allow the child to breath spontaneously throughout the procedure.