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Sedation in the Pulmonary Function (PF) Lab
A trip to the PF Lab may be a scary experience for a child. During your child's visit, he or she requires a procedure done to either diagnose or treat a problem. Fear of pain, an unfamiliar environment and separation from loved ones can make cooperation difficult or impossible for a young child. Procedural sedation, the use of medicines to cause sleep and to decrease anxiety and/or pain around a procedure, can help ensure your child's safety and comfort, and enable successful completion of the planned test or procedure. At Children's Hospital Oakland, specially trained doctors and staff committed to your child's safety, comfort and well-being will care for your child when he or she requires sedation for a test or procedure. Who will care for my child during a test or procedure that requires sedation? In the PF Lab, specially trained pediatric physicians, nurses and respiratory technicians will sedate and monitor your child. What medications will be used? In choosing sedative medications, the physician caring for your child will consider a number of factors: the type and duration of the planned procedure, your child's age and any other medical conditions that may be present. Your physician will assess your child and discuss the medications with you before proceeding. Is sedation safe? Safe sedation practice begins with careful assessment of your child, familiarity with the unique responses of children to sedative medications, careful observation and monitoring of your child during and after the procedure, and maintaining a constant state of readiness to intervene should the level of sedation progress to a deeper level than intended. The professionals at Children's Hospital are 100 percent committed to the care of children, and we have an impressive safety record. The intended effects of medications used for sedation can be relief of pain, anxiety, and frequently, a drug-induced sleep. Common side effects of these medications include slower, shallower breathing and changes in blood pressure. These side effects become more common and more pronounced as the level of sedation deepens. Children who are sick or frail may be more susceptible to these side effects. Other common side effects of sedative medications may include unusual dreams, vomiting and sleepiness or agitation after the procedure. Your child's sedation provider will discuss the risk and benefit of planned medications with you prior to your child's procedure. How can I prepare my child for sedation? Sedation is safest on an empty stomach. In an urgent or emergent situation, we must weigh the risk of a "full stomach." Your sedation provider will consider your child's specific situation and recommend what he or she feels is in your child's best interest. Please do not give your child anything to eat or drink while in the PF Lab without checking with a staff member. Ask the physician about prescription medications that may be due or past due during the time you are in the PF Lab, and do not give them yourself without first discussing it. Talk to your child honestly, on their level, about what will happen once they are sedated. Even young children will benefit from your calm reassurance. How long will it take my child to recover? Recovery time following sedation can vary depending on your child's underlying diagnoses, the medications used, and the length of the procedure. Recovery may be as brief as 30 minutes and as long as 1 to 2 hours. What can I expect during the recovery period? May I be present during this time? We believe that children should be reunited with their parents as soon as possible after their procedure is completed. Children may have a variety of responses to sedation. Children may prefer to sleep; in this situation it is best to allow them to awaken naturally. Others may be restless, agitated, or tearful. This is a temporary situation. As a parent you will be most helpful to your child if you remain calm and in control. When is my child ready to be discharged? During the recovery period, your child will be closely monitored and cared for by a nurse specially trained in post-sedation care. When your child is ready to be discharged, whether to home or to another part of the hospital, he/she may still be drowsy but otherwise will have achieved his/her presedation baseline. If my child is to be discharged from the hospital after a procedure , how should I take care of him? You will be given complete
discharge instructions before you
leave the hospital.
F.A.Q.
WHAT TEST WILL OCCUR? SEDATED INFANT PULMONARY FUNCTION TEST WHAT IS THIS TEST? SEDATED INFANT PULMONARY FUNCTION TESTS (PFT) measure how well your lung is working. The tests involve breathing into a device attached to computers. We can measure how big the lungs are and how well they are working.The test will measure your child’s breathing when your child is breathing quietly. Your child will be given sedation to help your child sleep and cooperate for the test. WILL THE TEST HURT? No. IS THE SEDATION SAFE? Sedation will be given by a doctor.There are some risks with sedation such as allergic reactions to sedation medicine or becoming too sleepy with medication. Your child will be monitored carefully for potential problems. IS THE TEST SAFE? Yes. There are no risks from performing this test. HOW DO I KNOW THE TEST IS AUTHORIZED? In general, the doctor referring you for the test will already have arranged for authorization for your test by your insurance company. But it is your responsibility to have authorization before the test. Be sure to talk with the pulmonary office and confirm that the authorization is completed. WHERE DO I REGISTER? Register for the test at the hospital registration area 30 minutes before the test is scheduled. WHERE WILL TEST OCCUR? For Children’s Hospital Oakland, go to the Sleep Laboratory on the 2ND Floor of Main Hospital. @747 52nd Street in Oakland. For California Pacific Medical Center, go to the Pediatric ICU on 3rd Floor of Pacific Campus at 2333 Buchanan Street (at corner of Buchanan and Clay Streets. HOW LONG WILL THE TEST TAKE? The test itself will take about 4 hours. However, when you add parking, registration and instruction time, you should allow at least 6 hours for the entire test. HOW SHOULD MY CHILD DRESS FOR THE TEST? Normal clothing is fine. SHOULD MY CHILD TAKE REGULAR MEDICINE BEFORE TAKING THE TEST? Unless your doctor tells you otherwise, do NOT use these medications: Xopenex and Duoneve for 12 hours prior to test. CAN MY CHILD EAT BEFORE THE TEST? NO. Because your child may need medication to help your child sleep, your child should not eat. Please follow the following schedule: No breast milk 4 hours before test. No clear liquids (any you can see through) 4 hours before test. No solids (cow or soy milk) 8 hours before tests. WILL MY CHILD BE GETTING ANY MEDICATIONS FOR THE TEST? Yes. Your child may also be given albuterol or xopenex. Your child will be receiving SEDATION to help your child sleep quietly for the test. Chloral hydrate is typically used. Chloral hydrate is a safe medicine that is sweet, sticky and slightly bitter. It usually works well. Sometimes, IV medications are used. HOW CAN I HELP MY CHILD FALL ASLEEP AND STAY ALSEEP FOR THE ENTIRE TEST? To help your child sleep for the test, please SLEEP DEPRIVE YOUR CHILD by putting your child to bed later than usual the night before the test AND by waking your child up early the day of the test. A child who is already tired will need less medication for sedation. DO I NEED TO TAKE ANY SPECIAL PRECAUTIONS AFTER THE TEST? Your child may be dizzy, sleepy, or nauseated because of the sedation. Your child may drink clear fluids after waking fully. Move to regular diet as tolerated. Don’t let your child run around unattended since he/she may be a little clumsy after the medicine. The day after the test your child should be fully back to his/her normal. SHOULD I DO THE TEST IF MY CHILD IS SICK? NO. This test is usually used to measure how you are doing on a regular day. If your child is sick, the test will need to be cancelled - unless your doctor says you should still do the test. Please call the lab as soon as you think you will not be able to do the test. We will need to reschedule the test. WHAT SHOULD I DO IF I NEED TO CANCEL OR RESCHEDULE THE TEST? Notify the Pulmonary office at (510-428-3305) AND the Pulmonary Function Lab (CHO 510-428-3311; CPMC 415-428-3995) ASAP. If your child needs to have the test cancelled or rescheduled, we need to know as soon as possible so that we can allow another child to get tested. If you need to cancel the test the weekend or night before the scheduled test, please call the pulmonologist on-call at 510-428-3000 and notify the doctor that they must contact the PFT lab right away. If you cancel the test, without a valid reason, with less than 24 hours notice you will be charged a fee. HOW DO I FIND OUT THE RESULTS OF THE TEST? A copy of the results will be sent to your regular doctor and any specialist who referred you for the test. Your doctors should have the results of the test within 2 weeks. WHAT DO THE TEST RESULTS MEAN? Your lung doctor should discuss the results of the tests with you and your child’s doctor. WILL MORE TESTS NEED TO BE DONE? This will be up to you and your doctor.
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