Doing Pediatric Lab Survey

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Doing Pediatric Lab Survey

Postby kathie2ark » Sat Jun 21, 2008 5:42 am

I work at an acredited Pediatric sleep center where we do out-patient and in-patient PSG and CPAP/BIPAP on neonates through 22 years of age.

Our lab has been using low dose Chloral Hydrate P.O. as a mild sedation for quite some time. The criteria is inability to fall asleep for more than one hour, or to assist with hook-up for very apprehensive or combative patients.

Can all of you that work in an acute or non-acute stand alone pediatric lab let me know whether you use sedation or not, and if so what you use, and if not how you handle extremely difficult patients with behavior issues, autism, Downs. etc.?

Thanks......
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Re: Doing Pediatric Lab Survey

Postby Jayhawkhenry » Sun Jun 22, 2008 1:18 pm

kathie2ark wrote:Our lab has been using low dose Chloral Hydrate P.O. as a mild sedation for quite some time. The criteria is inability to fall asleep for more than one hour, or to assist with hook-up for very apprehensive or combative patients.


We use the same plan on some cases. We have also used Zolpidem with great success. I am not sure there is a "magic bullet" to use when working with high acuity children.
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interesting

Postby labman2 » Tue Jun 24, 2008 10:54 pm

what background does the person have giving the meds- or does the parent administer the meds they have been given previous to the study night?

I am just wondering as we are about to see more of these types of pediatric patients.

Thanks

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Re: Doing Pediatric Lab Survey

Postby kathie2ark » Thu Jun 26, 2008 2:59 pm

Jayhawkhenry wrote:
kathie2ark wrote:Our lab has been using low dose Chloral Hydrate P.O. as a mild sedation for quite some time. The criteria is inability to fall asleep for more than one hour, or to assist with hook-up for very apprehensive or combative patients.


We use the same plan on some cases. We have also used Zolpidem with great success. I am not sure there is a "magic bullet" to use when working with high acuity children.


That's a big help thanks.
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Re: interesting

Postby kathie2ark » Thu Jun 26, 2008 3:01 pm

labman2 wrote:what background does the person have giving the meds- or does the parent administer the meds they have been given previous to the study night?

I am just wondering as we are about to see more of these types of pediatric patients.

Thanks

Labman2


Although we are physically in the hosptial our pt's are considered out-patients (but then we do inpatients as well) so the meds are given to the patient by the parent. We order the meds from the pharmacy but the parent signs for it and administers it to the child.
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Postby nitenitebaby » Tue Jul 15, 2008 8:58 pm

I work at an Accredited Ped Sleep Center. We do not sedate our patient's. We do Downs, Trachs, Severely disabled, you name it we do it, BUT we do NOT sedate our patient's. We complete the study with them taking only their regular scheduled medications with no changes within the 2 weeks prior. Sedation will change their normal sleep.
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Re: Doing Pediatric Lab Survey

Postby stars » Wed Jul 16, 2008 10:54 pm

kathie2ark wrote:I work at an acredited Pediatric sleep center where we do out-patient and in-patient PSG and CPAP/BIPAP on neonates through 22 years of age.

Our lab has been using low dose Chloral Hydrate P.O. as a mild sedation for quite some time. The criteria is inability to fall asleep for more than one hour, or to assist with hook-up for very apprehensive or combative patients.

Can all of you that work in an acute or non-acute stand alone pediatric lab let me know whether you use sedation or not, and if so what you use, and if not how you handle extremely difficult patients with behavior issues, autism, Downs. etc.?

Thanks......

As RPSGT you cant give any meds to child .Do you have RN as night staff.
I work with child long time we Never use any meds for sedation. Who set up meds to you patient how you know interraction with another meds what child use????
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Postby polysomprincess » Thu Jul 17, 2008 3:59 pm

Having previous experience at an acute childrens hospital sleep lab...we never used any drugs to sedate....patience is a virtue with these little tykes....besides drugs can skew the study....
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Postby pgsrpsgt » Thu Jul 17, 2008 7:21 pm

Anytime a normally non-sedated patient is sedated with anything the study should not be considered an accurate baseline of the patient as sedation also supresses respirations. Now you have an interpretation problem. If the study is positive (apnea) you cannot say whether it was due to the sedation or if the child really has a problem. A child should only be sedated for a sleep study if they are sedated every night of their young lives and the MD orders the study that way. Chloral is often used in EEG to get sleep in order to maximize the chances of finding discharges. Somehow this sedation got transfered to sleep studies - mainly in Neuro departments. Agree with the Princess-patience works better for me than sedation.
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Postby LaloriaSleeps2 » Thu Aug 21, 2008 12:23 am

I would have to agree with nitenitebaby...We do not sedate and we are an accredited pediatric sleep lab as well. It takes alot of patience and team work.. We have these patients go to clinic prior to scheduling the study just to get a sense of how difficult the child may be.. We have Child Life Services available to educate the family and the child. If they are coming in for titration we allow them to go home with the mask and get acclimated to it. I hope this helps
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Postby karenL » Thu Aug 21, 2008 12:34 am

We are an accredited lab and we do all ages. We do give Chloral Hydrate if ordered. Only RPSGT's here. I have noticed that often with kids with FAS it has a reverse effect. I try to avoid sedation if possible.
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Postby Don't Dream & Drive! » Thu Aug 21, 2008 4:16 am

We are an accredited lab also & do not sedate adults or peds. If it is their regular medication, they are allowed to take it. We have them come to clinic first and we are able to observe their behavior. We also ask the parents how they think their children will behave. You should do 1 on 1 study with these difficult children.This gives the tech plenty of time to help the child relax. We do have some children that are fiesty, sometimes we measure & mark the head, then paste the leads on when they fall asleep. Works good for us :D
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Postby RPSGT88athome » Thu Aug 21, 2008 9:49 am

I agree about Zolpidem. There are pediatric studies going on right now with that compound.

Chloral Hydrate and other sedatives...I don't like them anymore. Respiratory Depression and other issues.

Personally, I think monitoring their vital signs while and during tying them up like a bunny and letting them cry and fall asleep without meds is the best answer.

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Postby MrBig » Thu Aug 21, 2008 11:06 am

Sometimes, I wanna sedate myself before shift. Does this count?
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Postby Sleepladypalmdesert » Thu Aug 21, 2008 12:44 pm

Oh man...I hear you Big. I can remember when I was doing technical work in Neurology. There were times I would have appreciated a little sedation for both me and the patient.
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