Recovery After Procedural Sedation (Child)

Driving your child home after procedural 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 to drive and the other to sit next to the child. The adult sitting next to the child should closely observe the child's head position to avoid airway obstruction.

Home care

Follow these guidelines after your child returns home:

• Stay with your child until they are fully awake.

• Watch your child closely for the first 12 to 24 hours after the procedure. Don’t leave your child alone in the bath or near water. Don't let your child skateboard, skate, or ride a bike until they're fully alert and have normal balance. This is to help prevent injuries.

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

• It’s OK to let your child sleep. But always ask your child's healthcare provider how often you should wake your child. When you wake your child, check for the signs in "When to seek medical advice" (below).

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

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

• If your child is old enough to drive, don't allow them to drive for at least 24 hours. Your child should also not operate heavy or dangerous machinery or make any important business or personal decisions during this time.

Follow-up care

Follow up with your child's healthcare provider as advised. Call the provider if you have any concerns about how your child is breathing. Also call the provider if you're concerned about your child's reaction to the procedure or medicine.

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're 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 s. 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 get medical care

Call your child's healthcare provider right away if any of these occur:

• Drowsiness that gets worse

• Weakness or dizziness

• New rash

• Repeated vomiting and can't keep down clear liquids

• Cough

• Fast breathing

• Slow breathing

• Your child slurs their words, and you can't understand them

• Not acting like themselves

• Fever within 24 hours of going home (see fever and children below)

Call 911

Call 911 if your child has any of these:

• Trouble breathing

• Chest pain

• Loss of consciousness or they can't wake up as normal

• 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 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 healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

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

When to call a healthcare provider about your child’s fever

For a baby under 3 months old:

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

• Rectal or forehead: 100.4°F (38°C) or higher

• Armpit: 99°F (37.2°C) or higher

• A fever of ___________as advised by the provider

For a child age 3 months to 36 months (3 years):

• Rectal or forehead: 102°F (38.9°C) or higher

• Ear (only for use over age 6 months): 102°F (38.9°C) or higher

• A fever of ___________ as advised by the provider

In these cases:

• Armpit temperature of 103°F (39.4°C) or higher in a child of any age

• Temperature of 104°F (40°C) or higher in a child of any age

• A fever of ___________ as advised by the provider