TIPS

A nursing
perspective on

sedating children
for CT scanning

Having been a Professional Nurse
in the CT Scanning Department at the
Red Cross Children's Hospital since
1987 and having had to prepare chil-
dren for CT scanning, I have found
that the following groups of children
almost always need to be sedated for
the investigation: infants, toddlers, un-
cooperative children, those having
long examinations and those who are
developmentally delayed. We try to
reason with older children before the
examination and if we feel they will
not lie still, we then sedate them. Pre-
assessment of children who are at risk
of respiratory arrest is undertaken and
sedation for these patients is admin-
istered only by the attending physi-
cian.

We use the following pharmaco-
logical agents:

Barbara Duminiet
Chief professional nursa: ganeral nursing,

midwifery, paediatrIc nursing science

CT Scanning Department,
Red Cross War Memorial Children:S Hospital,

Rondebosch, 7700, Cape Town
Tal: (021) 858·5422. Fax: (021) 658·5101.

E-mail: rxcfscan@pawc.wcape.gov.za

1. Chloral hydrate (not available
commercially, but made up by our
local pharmacy) 75 mg/kg. If the child
has not fallen asleep after an hour, a
top-up dose of 25 mg/kg is given, thus
making a maximum dose of 100 mg/
kg that a child may receive.

2. Vallergan Forte (trimeprazine tar-
trate) 4 mg/kg (manufactured by
Rhóne-Poulenc Rorer SA (Pty) Ltd).

80 SA JOURNAL OF RADIOLOGY. February 2001

3. Paxical5 mginjection (droperidol)
0,2 mg/kg given orally (manufactured
by Pharmacare Ltd).

Neonates are not sedated. Prior to
the examination they are given a feed
and wrapped up warmly. Children
with a history of hyperactivity are
given Vallergan and droperidol orally
as this seems to work better than chlo-
ral hydrate. Those children having
long examinations, e.g. chest and ab-
dominal scans, are also given Vallergan
and droperidol, as this is long-acting.
Children with trauma injuries are se-
dated only if they are restless and the
sedation is administered only by the
attending traumatologist.

In my experience, sedating chil-
dren requires a great deal of patience
and an understanding that each child
is different. Some children take longer
to fall asleep and others may react
differently to various sedatives, e.g.
some children become hyperactive
after being given chloral hydrate, some
children become very tearful and oth-
ers will go to sleep peacefully.

We try to create a child-friendly
environment by having a play area
with toys, books and puzzles. To as-
sist us in our efforts to get the chil-
dren to sleep, we darken the area by
closing the curtains, switching the
lights off and keeping the noise level
down. Parents play an important role
in the management of children, help-
ing with explanations about the ex-
amination and allaying any fears that
the child may have.

I hope these tips will assist clini-
cians and nurses in sedating children,
thereby avoiding general anaesthesia
or the dangerous use of intravenous
benzodiazapines.

mailto:rxcfscan@pawc.wcape.gov.za