After Your Child Has Procedural Sedation

Procedural sedation is medicine to keep your child safe by preventing them from moving during a procedure. It also helps ease discomfort, pain, and anxiety during a procedure. The medicine is often given through an IV (intravenous) line in the arm or hand. In some cases, the medicine may be taken by mouth or breathed in (inhaled).

Driving your child home after sedation

Children may be at a higher risk of an airway obstruction if their head falls forward while secured in a car safety seat. If your child uses a car safety seat, it is recommended that 2 adults be with the child to drive home. One adult drives and one adult sits next to the child. The adult sitting next to the child should closely observe the child's head position to prevent airway obstruction.

Care at home after sedation

Your child will likely be drowsy for a while. They may have a faint memory of the procedure, or may not remember it at all. Side effects of sedation, such as headache and nausea, may go away quickly. But drowsiness may continue. How long this lasts will depend on the medicine your child receives. Ask your health care provider how long you can expect your child to be drowsy.

Follow these guidelines after your child returns home:

• Stay with your child until they are fully awake.

• Check your child’s breathing for 12 to 24 hours as noted below.

• Let your child sleep if needed. But ask your child's provider how often you should wake your child.

• Don’t give your child any medicine during the first 4 hours after the procedure unless the provider tells you to. Some medicines, such as those for pain or cold relief, might react with the medicines your child was given in the hospital. This can cause a much stronger response than usual.

• Don’t leave your child alone in the bath or near water.

• Help your child walk or crawl if they are unsteady. They are at a higher risk of falling for the next 24 hours.

• Don't let your child skateboard, skate, or ride a bike until they are fully alert, are feeling better, and have normal balance. This is to help prevent injuries.

• If your child is old enough to drive, don't allow them to drive for at least 24 hours. Also, do not let them operate other dangerous or heavy machinery during this time.

• Don’t ask your child to make any big decisions for at least 24 hours.

• Follow any instructions you were given for your child's eating and drinking.

Checking your child's breathing

Sedation can affect breathing after the procedure. Watch your child closely for the first 12 to 24 hours at home. Check that they are breathing normally during this time. One breath is counted each time your child breathes both in and out.

Normal breathing is:

• For newborn to 3 months old: 34 to 57 breaths per minute.

• For a baby 3 months to less than 6 months old: 33 to 55 breaths per minute.

• For a baby 6 months to less than 9 months: 31 to 52 breaths per minute.

• For a baby 9 months to less than 12 months old: 30 to 50 breaths per minute.

• For a child 12 months to less than 18 months old: 28 to 46 breaths per minute.

• For a child 18 months to less than 24 months old: 25 to 40 breaths per minute.

• For a child 2 to less than 3 years old: 22 to 34 breaths per minute.

• For a child 3 to less than 4 years old: 21 to 29 breaths per minute.

• For a child 4 to less than 6 years old: 20 to 27 breaths per minute.

• For a child 6 to less than 8 years old: 18 to 24 breaths per minute.

• For a child 8 to less than 12 years old: 16 to 22 breaths per minute.

• For a child 12 to less than 15 years old: 15 to 21 breaths per minute.

• For a child 15 to 18 years old: 13 to 19 breaths per minute.

When to call the doctor

Call your child's health care provider right away if your child:

• Has drowsiness that gets worse.

• Has weakness or dizziness that gets worse.

• Has repeated vomiting and can't keep down clear liquids.

• Has a new rash.

• Has a cough.

• Has fast breathing.

• Has slow breathing.

• Slurs their words, and you can't understand them.

• Is not acting like themself.

• Has a fever within 24 hours of going home (see fever and children below).

Call 911

Call 911 if your child has:

• Trouble breathing.

• Chest pain.

• Loss of consciousness or they can't be awakened as usual.

• Choking or coughing episodes.

• Trouble swallowing.

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The health care provider may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the provider what type to use instead. When you talk with any health care provider about your child’s fever, tell them which type you used.

Below is when to call the provider if your child has a fever. Your child’s provider may give you different numbers. Follow their instructions.

When to call a health care provider about your child’s fever

First, ask your child’s provider how you should take the temperature.

For a baby under 3 months old, call your child's provider if:

• The rectal or forehead temperature is 100.4°F (38°C) or higher.

• The armpit temperature is 99°F (37.2°C) or higher.

• Your child has a fever of ___________as advised by the provider.

For a child age 3 months to 36 months (3 years), call your child's provider if:

• The rectal or forehead temperature is 102°F (38.9°C) or higher.

• The ear temperature (only for use over age 6 months) is 102°F (38.9°C) or higher.

• Your child has a fever of ___________ as advised by the provider.

Call your child's provider if:

• The armpit temperature is 103°F (39.4°C) or higher in a child of any age.

• The temperature is 104°F (40°C) or higher in a child of any age.

• Your child has a fever of ___________ as advised by the provider.