sedation a guide for parents and carers

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1 Women and Children s Directorate sedation for your child s test or treatment a guide for parents and carers

2 Contents... 1 Sedation for a test or treatment 2 For parents or carers bringing their child to the hospital For parents or carers whose child is already in the hospital At the hospital Going home

3 Se d at i o n fo r a t est or treatment 1 What is sedation? Sedation means feeling relaxed, free from fear, anxiety, pain and distress. These feelings are produced by drugs called sedatives. Why does my child need sedation? Sometimes children need sedation for a test or treatment at the hospital. This can be for a number of reasons: * if your child is anxious or distressed about a test or treatment * if a test is sore or uncomfortable * because we need your child to lie very still for a test or treatment About sedation medicines How will my child be given the sedation medicine? You and your child can often choose how the sedation medicine is given. A doctor will talk to you about this at the hospital. There are 3 ways sedation medicine can be given: 1. A liquid medicine or tablet your child can swallow. 2. A gas (called Entonox) your child breathes in through a mouthpiece. 3. An injection. How long do they take to work? Liquids & tablets - take up to an hour to work. Gas - works straight away Injection - your child may become sleepy very quickly. How safe are sedation medicines? Modern sedation medicines are safe and complications are rare. For a child in good health having a minor test or treatment: 1 child in 10 might have a headache, feel sick or dizzy, or be sick. 1 child in 25 might get so restless that the test or treatment has to be cancelled.

4 Are there any side effects? Some children will feel or be sick. This should only last for a short time. We can give your child medicine to help with this. What happens if the sedation doesn t work? If the sedation medicine doesn t work the doctor will either try a different type of sedation or cancel the test or treament for that day. The doctor will tell you what will happen next and answer any questions you have. I have been told that I cannot choose which type of sedation medicine my child has. Sometimes you will not have a choice about how the sedation medicine is given. If this happens everything will be explained to you. Nothing will happen unless you understand and agree with what has been planned. The wishes of you and your child are very important - we will work with you to give the best possible care for you and your child. What should I tell my child about sedation? We have designed a leaflet for children. You should have been given a copy with this booklet. If you do not have one, please phone the Family Support & Information Service on /0707 If your child is old enough let them read this. Discuss it with them afterwards. If your child is not old enough to read, you can use the information in the leaflet to help explain things to them.

5 Fo r pa r e n t s o r c a r e r s b r i n g i n g their child to the hospital 2 What should I tell my child about going to the hospital? All children (except infants) should be told that they......are going to the hospital...will be having a test or treatment Here are some tips: tell them the test or treatment will help them use simple words get your child to talk about the test or treatment try and answer all their questions tell them when the test or treatment is tell them if they will have to stay in hospital if your child has to stay overnight, let them know if you can stay with them. If you cannot stay let them know when you will visit them. let your child pack their bag and decide what pyjamas and toy they want to take. When should I tell my child? As a rule: Children aged 2-3 years should be told 2-3 days before admission and again on the day of admission. Children aged 4-7 years should be told 4-7 days before admission and again on the day of admission. Older children will usually be involved in making decisions about the test or treatment. Discussion should take place a few weeks before admission.

6 Visiting the hospital before the day of the test or treatment You can visit the hospital before the day of your child s test or treatment. This is called a pre-admission visit. At this visit your child will meet a play specialist or nurse. They will tell your child what will happen on the day of their test or treatment and answer any questions. If you want to come for a pre-admission visit please call: and ask for the Play Specilaist. Do I need to tell the hospital anything before my child comes for their test or treatment? You should let the hospital know if your child has any special needs. You should phone the hospital if your child develops a severe cough or cold OR has contact with infections like chickenpox, measles etc. shortly before the day of the test or treatment. Eating and drinking before the hospital test or treatment It is very important that your child s stomach is as empty as possible. This will mean there is less chance of your child vomiting during or after sedation. The latest times you can give your child anything to eat or drink are: 6 hours before your child can have a light non-fatty meal like cereal, toast, fruit, yoghurt, and a glass of milk or a fizzy drink, bottle fed babies can have some formula feed 4 hours before babies can have breast milk 2 hours before all children and babies can have a drink of water or dilute cordial If your child takes regular medicines you will be told if you can give these. You should not eat or drink anything in front of your child when they are not allowed to.

7 Fo r pa r e n t s o r c a r e r s w h o s e child is already in hospital 3 What should I tell my child about the test or treatment? Tell them the test or treatment is to help them. Use simple words. Encourage your child to talk about the test or treatment. Try and answer all their questions. Tell them when the test or treatment is. Tell them if they will have to stay in hospital. If your child has to stay overnight, let them know if you can stay with them. If you cannot stay let them know when you will visit them. Eating and drinking before the hospital test or treatment A doctor or nurse will tell you what your child can eat or drink and when they can do this. You must not give your child anything else. You should not eat or drink in front of your child when they are not allowed to.

8 At t h e h o s p i ta l fo r a test or treatment 4 Seeing a doctor or nurse before the test or treatment A doctor or nurse will talk to you and your child before the test or treatment. They will ask you about: - your child s general health - any previous sedation your child has had - any medicines your child is taking - any allergies your child has They will discuss the type of sedation medicine your child will be having. This is also a good time to talk about any experiences your child has had with injections or hospitals. You can ask about any concerns you have - it might be helpful to make a list of questions you want to ask. Occasionally, the doctor or nurse will learn something about your chid that means it would not be safe to carry out the test or treatment that day. This could happen if your child has... a bad cold a rash eaten food too recently The doctor will arrange another appointment for your child. Getting the sedation medicine Some children will be given their sedation medicine in the ward before going to the treatment area. This usually happens if the sedation medicine is going to take some time to work. Some children will be given their sedation medicine in the treatment area.

9 A doctor or nurse will tell you when and where you child will get their sedation medicine. You can usually stay with your child until they are sedated. Your child can usually sit on your lap while getting the sedation medicine. Going to the treatment area A nurse from the ward will go with you and your child to the test or treatment area. Your child can take a toy or comforter. Your child will either have their own clothes on or one of our colourful gowns. Your child will be able to keep their underwear on. Your child will either walk; be carried or go on a trolley to the treatment room. The Day Surgery Ward has a toy vehicle that young children can drive. The test or treatment Your child is now ready for their test or treatment. The nurse or doctor will tell you if you can stay with your child during the test or treatment. If you cannot stay they will tell you why. Trained staff will closely monitor your child s pulse, oxygen level and breathing during the test or treatment - ensuring your child is safe and comfortable. After the test or treatment Most children go to a recovery area. You can usually be with your child in the recovery area as they wake up. A nurse will look after your child until they are well enough to go back home.

10 Going Home 5 If your child is sent home on the same day as their test or treatment: They might have some pain or discomfort - the hospital will give you some pain relieving medicine. They will explain how to use this. Encourage your child to eat a light meal or snack and have a drink. Do not give them fatty foods. Do not give them large amounts to eat or drink. Children sometimes feel or are sick after leaving hospital. If your child continues to be sick please phone and ask for the on-call registrar or to speak to the nurse in charge of the ward that your child was in. Some parents or carers find that their child does not sleep as well after being in hospital or is a little more clingy or difficult than usual. Do not worry, this is a normal reaction to being in hospital However, if you are worried about your child for any reason after being in the hospital please phone and ask for the oncall registrar or to speak to the nurse in charge of the ward that your child was in.

11 Further information You can get more information from: Action for Sick Children (Scotland) Children s Hospital Medical Centre of Cincinnati Your_Childs_Health/Pain_Management/Sedation/ Sedation.htm SIGN Guideline 58 Royal college of Anaesthetists Dr Neil S Morton Consultant in Paediatric Anaesthesia & Pain Management Department of Anaesthesia The Royal Hospital for Sick Childen Glasgow

12 MIS RHSC b

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