BRYN MAWR, Pa. (April 2005) -  Keeping a wiggling two-year-old still for certain tests and outpatient procedures poses a challenge for doctors who turn to the help of sedation to treat the child.  

Because sedating children is significantly different than sedating adults, Bryn Mawr Hospital recently established a Pediatric Sedation Service to ensure the safe, structured, and monitored administration of sedatives.

Safety is the primary concern when administering sedation to young children, according to Jared Caruso, MD, director of the Inpatient Pediatric Unit for the Bryn Mawr Hospital's duPont Children's Health Program. "Children have different anatomical and physiologic considerations and all the drugs have different pharmacokinetics in children." 

Dr. Caruso instituted protocols at Bryn Mawr Hospital that assess a child's risk factors for possible adverse reactions to medications; prepare a child for sedation; and monitor a child during sedation. "We offer a needed service to patients in the hospital and to outpatients who are referred here for tests or procedures that may be painful or require the children to be immobilized," he said.
 
Radiologic tests, such as magnetic resonance imaging (MRI) or computed tomography (CT) scans account for a significant number of pediatric sedation cases, said Dr. Caruso.

"The MRI, for example, is loud and could scare a young child who must remain completely still throughout the exam," he explained. Pediatric sedation is also used for joint injections, biopsies, spinal taps, catheterizations, removal of foreign bodies, and orthopedic procedures.

Proper sedation techniques assure parents their children will be safely cared for and allow medical personnel to accurately complete a test or procedure and supply timely diagnostic information to physicians. In addition to its diagnostic uses, sedation has emotional benefits in that it allays a child's fears and relieves anxiety.

"It is important to offer this service, not just in children's hospitals, but in community hospitals near where families reside," said Dr. Caruso, who came to Bryn Mawr last year from Texas, where he began a similar program at the children's hospital of the University of Texas Medical Branch at Galveston. "At Bryn Mawr, we have the physician presence and expertise, nursing expertise, and a shorter turnaround time to schedule tests and deliver results than a larger hospital with greater volumes," he explained.

The development of pediatric sedation programs began nationwide about 10 years ago in children's hospitals after a review of sedation cases with adverse results found a wide variation in attempts to accommodate the need for pediatric sedation in hospital settings, ranging from the emergency room to radiology to the pediatric inpatient floor.

Media Contact: Frieda Schmidt, 610-526-8763

Published:4-4-2005