Preparing for Scans and Procedures: Strategies for Your Child's Safety and Comfort
Our goal at St. Jude is to keep your child comfortable and safe during scans and procedures. Your care team will work with you to develop a plan for your child based on their age and medical needs. The available options will also depend on the type of scan or procedure.
Each patient is different. We will work together to figure out what works best to help your child be successful.
Options may include:
Practice sessions in a mock scanner
Coping strategies to reduce anxiety
Positioning aids to make your child more comfortable and help them stay still
Entertainment options during the scan or procedure
Medicines to reduce discomfort or help your child relax
Sedation or general anesthesia if needed
Our goal is to limit the use of general anesthesia for certain scans and procedures. Your care team will talk to you about options that are appropriate for your child.
Non-medicine strategies that can help during scans and procedures
Ways to help your child get ready for scans or procedures may include:
Explain what to expect including what they will see, hear, and feel.
Have your child practice being still at home; make it a game and have them try for longer times.
Use coping strategies like deep breathing and relaxation exercises.
Plan for entertainment during the scans or procedures, like listening to music or watching a movie.
Bring a comfort item like a stuffed animal or blanket.
If a scan is early in the morning, have your child stay up a little later than normal the night before. If the scan is late in the day, have your child get up early or avoid napping before the scan time. Your child is more likely to fall asleep during the scan if they are tired.
Your care team will work with you to develop a plan for your child based on their age and medical needs. The available options will also depend on the type of scan or procedure. Ask your care team about the options for your child.
Each patient is different. We will work together to figure out what works best to help your child be successful. A child life specialist or psychology team member may help your child practice in a mock scanner and learn coping and relaxation strategies.
Staff will also help you know what options are available depending on the type of scans or procedures.
What medicines may be used instead of general anesthesia?
Your care team may recommend medicines that can help your child stay calm and still during scans or procedures as an alternative to general anesthesia. These include sedation medicines that make your child feel sleepy or relaxed. Other medicines include medicines to decrease pain or reduce anxiety.
Common sedation medicines include Versed (midazolam), Precedex (dexmedetomidine hydrochloride), Ativan (lorazepam), and Benadryl (diphenhydramine). These can be given through a vein by IV or by mouth, depending on the scan or procedure and your child’s needs.
What is the difference between general anesthesia and sedation?
General anesthesia causes a complete loss of consciousness. It is often described as a “deep sleep.” But unlike normal sleep, your child will not feel sensations such as pain. Your child may breathe in the medicine through a mask or breathing tube. Or they may get medicine through a vein by IV.
There are different levels of sedation: mild, moderate, and deep.
With mild sedation, your child may feel sleepy or relaxed.
When under deep sedation, patients are usually unaware of their surroundings, but they might respond to stimulation, such as being asked to open their eyes.
Our goal is to help reduce the use of general anesthesia when possible. Sedation medicines are one option that your care team might recommend.
What are the benefits of limiting general anesthesia for scans & procedures?
Benefits include:
Fewer risks and side effects: Anesthesia is generally safe, but there are potential risks and side effects. You avoid these risks if your child stays awake. For example, some children may have side effects of anesthesia, such as dizziness or nausea. In addition, some research suggests that repeated exposure to anesthesia may cause changes in the brain, such as learning problems, trouble paying attention, or slower thinking
Shorter appointment times: Without general anesthesia, less time is needed for tests and exams before the scans or procedures. Your child will not have to spend time in recovery after the scan and will feel less groggy after the scan or procedure.
No fasting (NPO) needed once your child can stay awake for the scan: This means your child may not have to follow the fasting (NPO) guidelines for anesthesia and could eat and drink normally, depending on the scan or procedure. Your care team will let you know if your child cannot eat or drink before a scan. Always follow the instructions given by your care team to avoid a delay or schedule change.
Sense of control and accomplishment: Using coping strategies successfully can help your child feel more confident and in control of their environment. These skills can help them manage stress and cope with other medical procedures.
What if my child needs general anesthesia for scans or procedures?
Many children will need general anesthesia for some of their scans and procedures. It is also OK for your child to have anesthesia for some scans and not others.
We are here to support your child and provide the best possible care.
Our goal is to educate you on the available options and support your child at every step.
What happens if my child tries to stay awake, but can’t complete the scans or procedures?
If your scan or procedure is booked with general anesthesia, an anesthesia provider will be readily available to assist, as long as fasting (NPO) guidelines have been met.
It is also important to keep in mind that your child can try again another time if they are not successful at first.
If your child cannot stay still the first or second time, that’s OK. Your child can always try again during a future visit. Keep in mind that your options may be different for each visit, so ongoing communication with your care team is very important.
How will my child’s care team tell me about my options for staying awake?
If your care team thinks your child might be a good candidate for attempting an MRI or procedure without anesthesia, you will receive a phone call so you can discuss your options with someone from the anesthesia team.
You can also ask questions regarding your options in any anesthesia pre-clinic assessment visit.
A child life specialist is also available to speak with you about options.
We encourage you to ask questions and discuss your options with your care team for all care-related decisions. Ongoing communication is important. You can change your mind or choose different options at a later date.
How does anesthesia reduction impact my child’s schedule while on campus?
If your child is attempting an MRI scan without anesthesia, you will have 15 minutes of extra time built into your child’s scheduled appointment.
If your child is attempting a lumbar puncture without anesthesia, this time is already built into your child’s scheduled appointment.
If your child is not successful with their awake attempt, they can get sedation medicines or general anesthesia, as long as they followed fasting (NPO) guidelines.
For radiation therapy, extra time is not built into your appointment. Ask about your options ahead of time so that you can work with your care team to develop a plan for your child based on the type of scan or procedure.
How will the care team know if my child is able to stay awake for a scan or procedure?
Your care team will work with you to know if your child has a good chance of staying awake.
Questions we will consider include:
What is your child’s age?
What are the features and purpose of the scan (length of time, position) or procedure?
Has your child previously completed a scan or procedure without general anesthesia?
Does your child have a condition that might affect their ability to stay still or follow instructions, such as ADHD, autism, intellectual disability, or sensory processing disorder?
Can my child eat and drink before sedation?
Until you have been given other instructions, please follow all fasting (NPO) guidelines as instructed. Once your child has been successful awake and does not need anesthesia or sedation medicines, they may no longer need to fast before scans or certain procedures. However, until that time, it is important to follow fasting (NPO) guidelines in case your child is not successful in their awake attempt. If they need anesthesia and have not followed fasting guidelines, we will have to reschedule their scan or procedure.
Can my child take medications before general anesthesia or sedation?
Yes, in most cases. Always ask your provider which medicines your child should take. There are a few medicines that are not safe to take before anesthesia. Be sure you know the timing of the medicines and how to take them.
Contact a member of the Anesthesia team at 901-612-1256 to learn more.
Many children can have diagnostic imaging tests without anesthesia or sedation medicines. Learn strategies to help your child stay still and calm during scans.
Anesthesia is the use of medicines that alter consciousness and block sensations of pain during medical tests and procedures. Read about anesthesia in children.
