The Reading Room

Fire trucks and frogs: 5 ways to reduce the need for sedation in kids

by Sarah Hostetter

When it comes to kid-friendly imaging, safety concerns are often top of mind. For example, pediatric imaging providers regularly note the challenges associated with sedating children and seek ways to reduce the need for sedation and its associated risks whenever possible.

We wanted to take a deeper look at the way pediatric imaging programs are decreasing the need for sedation and how one organization put these strategies into practice.

Five tactics to mitigate need for pediatric sedation

Strategies like faster technology, physician training, or standardized protocols are often used to reduce the need for sedation. In addition to these techniques, there are five main process improvements imaging programs are using to reduce the frequency with which they have to sedate pediatric patients. These tactics work in one of two ways: educating patients before the exam to decrease anxiety or comforting and/or distracting them during the exam to prevent movement.

  • Child life specialists: Child life specialists are staff members who work with children and their families to make them feel more comfortable with their health care experiences. In imaging, these professionals can help children prepare for exams or even be present during the exam with the child.

  • Toy models: The models are toy-sized versions of imaging scanners that help familiarize children with the scan before their procedure and ease patient anxiety.

  • Audio-visual goggles: These goggles allow children to watch movies and listen to music during procedures, which can cancel out the loud noises and distract from the small space of the MRI machine, making it easier for children to stay still.

  • Sound acclimation: Simulations of MRI sounds can be played for children before their exams, either at home or in the hospital, to reduce the initial shock of the MRI noise.

  • Child-friendly themes: Scan rooms can be designed to create the feeling of an adventure, such as a jungle or sea, as opposed to a medical procedure. At Children’s Hospital of Pittsburgh, these adventure rooms have reduced sedations for CT scans of pediatric patients by 99%.

How one children’s hospital put these tactics into practice

One children’s hospital we spoke with uses a combination of the above approaches to help reduce the need for sedation with CT scans. They focused their efforts on CT scans since these are markedly shorter than MRIs, so children should be able to be managed with techniques other than sedation.

They use child life specialists to help the child and parent to feel as comfortable as possible. These specialists, to which the imaging director credits much of their sedation reduction, build a relationship with the child and parent before the procedure. They use visual aids, such as toy models, to give the child a sense of the procedure beforehand. For example, if the child will need contrast, they use a small toy frog to show how the child’s leg will be positioned for the catheter insertion. They are also available during the procedure if the child needs additional support or if the parent cannot be present due to pregnancy or other factors.

In addition, they have invested in pediatric-specific technology to create a more comfortable environment for children. They have fire truck and under-the-sea themed scanners to help make patients feel less like they’re getting a medical procedure. This combination of approaches has reduced their need for sedation during CT scans.

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