Sedation Alleviates Pain and Reduces Stress

Five-year-old Damon Oakley is like many boys his age. He likes video games, Sponge Bob Square Pants and pizza. There’s just one thing that separates the Cheboygan resident from his friends’his fight against acute lymphoblastic leukemia. Part of his treatment includes frequent spinal taps with chemotherapy and painful bone marrow biopsies. Thanks to advanced sedation techniques at Helen DeVos Children’s Hospital, Damon’s fight is a little easier.

“The ability to sedate children for uncomfortable procedures is beneficial for parents and children,” said John Kopec, M.D., division chief, sedation services. “Parents are often worried about how their child will respond to a test and children are anxious about being in a hospital in general. Sedation enables a child’s health care team to perform the necessary tests or procedures while easing fear and minimizing discomfort for patients. It’s a win-win situation.”

Sedation may be used for procedures that require the patient to lie very still, are painful or are anxiety provoking. The sedation team assists with numerous procedures in more than 20 pediatric subspecialties including bone and kidney scans, spinal taps, bone marrow biopsies, radiation therapy, radiology procedures such as MRI, CT and fluoroscopy, and endoscopies.

Patients are closely monitored during sedated procedures by a nurse or physician or both as needed. Sedations are performed in a child-friendly, reassuring atmosphere. Special attention is paid to putting the child at ease even before sedation begins. From picking out a temporary tattoo or blowing bubbles, pediatric specialists use a variety of techniques and distractions to diminish a child’s fear.

The sedation team at Helen DeVos Children’s Hospital typically uses deep sedation’a medically controlled state of reduced consciousness through the use of intravenous medications. The sedation team utilizes techniques that allow the patient to breathe independently without having a breathing tube or using a ventilator. The type of sedation used is carefully determined and monitored by a pediatric critical care physician.

In addition to happier children and parents, the program results in fewer repeated tests and better procedure outcomes.

“I can’t imagine what it would be like for Damon to undergo a spinal tap without being sedated,” said Tanya Gotta, Damon Oakley’s mom. “I was amazed when I found out that all hospitals do not sedate children for painful procedures. It’s not easy having a hospitalized child. Knowing the sedation team is available makes a big difference.”

Damon Oakley is just one of more than nearly 5,000 patients annually that benefit from the sedation team’s expertise. The Helen DeVos Children’s Hospital sedation team includes 10 critical care physicians, 23 nurses, two technicians and two child life specialists.’

The American Academy of Pediatrics (AAP) recently released updated sedation guidelines.

“Parents should be aware of the AAP guidelines and research how their hospital measures up to the requirements,” added Kopec. “Helen DeVos Children’s Hospital meets or exceeds each of the AAP guidelines. Parents should ask if sedation is available at their hospital or for a particular procedure.”

AAP Guidelines

No administration of sedating medications without the safety net of medical supervision.”
Careful pre-sedation evaluation for underlying medical or surgical conditions that would place the child at increased risk from sedating medications.’
Appropriate fasting for elective procedures and a balance between depth of sedation and risk for those who are unable to fast because of the urgent nature of the procedure.”
A clear understanding of the effects of the medications used for sedation as well as an appreciation for drug interactions.”
Appropriate training and skills in airway management to allow rescue of the patient should there be an adverse response.”
Age- and size-appropriate equipment for airway management and venous access, appropriate medications and reversal agents.”
Sufficient numbers of staff to both carry out the procedure and monitor the patient during and after the procedure.”
Appropriate physiologic monitoring during and after the procedure.”
A properly equipped and staffed recovery area, recovery to pre-sedation level of consciousness before discharge from medical supervision, and appropriate discharge instructions.’

Helen DeVos Children’s Hospital, a member of Spectrum Health, is West Michigan’s largest children’s hospital, serving children and families throughout a 37-county region. The team includes more than 100 specialists uniquely skilled in providing medical care to children, in over 40 outpatient clinical settings. Helen DeVos Children’s Hospital is committed to caring for children and families with compassion, excellence and innovation.