/clinical/,/clinical/references/,/clinical/references/afch-pediatric-resources/,/clinical/references/afch-pediatric-resources/sedation/,/clinical/references/afch-pediatric-resources/sedation/scheduling-communication/,

/clinical/references/afch-pediatric-resources/sedation/scheduling-communication/

201410304

page

100

UWHC,UWMF,

Patient Care,Pediatrics,

Clinical Hub,References,AFCH/Pediatric Resources ,Pediatric Sedation

Pediatric Sedation and Anesthesia Scheduling and Communication Guide

Pediatric Sedation and Anesthesia Scheduling and Communication Guide - Clinical Hub, References, AFCH/Pediatric Resources , Pediatric Sedation

Focus

Please DO NOT request sedation from both DTC and Anesthesia at the same time.

Sedation ProgramAnesthesia
Diagnostic and Therapy Center (DTC) (Sedation Clinic)

Overall Process:

  • Make patient NPO (see below)
  • Complete Pediatric Sedation Request Screening Form
  • Once information is received, DTC will process request
  • Tube request to station #911 and call DTC Coordinator at 2-4402 (HUC can do this)
  • The goal is to accommodate all pediatric sedation requests that can be done safely through the DTC
  • If DTC cannot conduct sedation (e.g. due to illness severity), DTC will facilitate directing request to Anesthesia by paging them to let them know that floor service will be contacting them
  • DTC will notify requesting service at that time also
  • Requesting service will then schedule Sedation with Anesthesia (see other side of chart)

Certain procedures/conditions that should be sent directly to Anesthesia:

  • DVI procedures
  • MRI in patients < 3 months of age
  • Obstructive Sleep Apnea (unless minimal sedation required)

Before setting up your request for anesthesia make sure you have:

  • Identified all the procedures that will need to take place (i.e. LP, bone marrow, lab draws, PICC placement, central line, physical exam) and list all of them on the anesthesia request form
  • Contacted the provider(s) who will be doing the procedure to make sure they are willing/available to do the procedure either “on call” to the OR and specify on the request card what time (s) they are not available
  • For PICC placements in the OR only (for now), contact Muggs Helin at pager #4383 (do not place a consult for VAT for OR placed PICCs)
  • Muggs is not to be called for sedation clinic or floor placement. For these areas VAT needs to be called and consult entered.

Complete the  Pediatric Sedation Request Screening Form.

It is imperative that the form is filled out completely or the request will not be honored.

  • Identify all the procedures that will need to take place (i.e. LP, bone marrow, lab draws, PICC placement, central line, physical exam) and list all of them on the request form
  • Contact the provider(s) who will be doing the procedure to make sure they are willing/available to do the procedure

Complete the  Anesthesia Request Card.

It is imperative that the card is filled out completely or the request will not be honored.

Include:

  • every procedure being done
  • contact person doing each procedure & pager/cell #
  • time of their availability
  • for radiologic exams and DVI, you do not need to specify time, just make sure the order is in HL and the OR will figure out the time
  • your name and pager #
  • your attendings name and pager #

Make patient NPO:

  • 2 hours for clear liquids
  • 4 hours for breast milk
  • 6 hours for formula/solids

 

For procedures done via anesthesia (which differs from surgical NPO) make patient NPO:

  • 2 hours for clear liquids
  • 4 hours for breast milk
  • 6 hours for formula/solids: a light meal is permissable 6hrs before a procedure but is not a good choice as it may delay the care of the patient. We often have last minutes changes in the OR schedule and your case may be moved up. If you child ate, you may lose the opportunity for the day
  • It is preferred that instead you use clear liquids/pedialyte on the day of the procedure. This will provide hydration and permit the earliest possible scheduling of the patient
  • See last page for surgical NPO guidelines

For Radiology Request—enter order ASAP

For Other Procedures (e.g. LP, PICC, Bone Marrow)—determine availability of individual performing requested procedure.

For Radiologic and DVI procedures make sure order is in Healthlink. For weekends, evenings, and holidays you must also call the radiology resident for any orders that you enter. On the weekday, you should call if you need to provide more information.

 

Discuss need for IV and IV fluids

Discuss need for IV and IV fluids

  • if unable to start IV make sure the child maintains hydration with Pedialyte up to two hours before called to OR

Submit Form to DTC

  • Deliver directly to DTC
    OR
  • Call DTC Coordinator @ 2-4402 and tube form to station #911 (HUC can do this)

After the above steps are completed, Monday through Friday, call the number below to alert them you have a case and you are “dropping a card” (HUC can do this).

  • For AFCH OR: call 0-7200 and speak with the Charge Nurse and tube the card to tube station #135
  • For weekend/holidays/off hours call the Main OR Control Desk @3-8595 and tube the request to station #132 (HUC can do this)

Assure that a family member (person that can consent) is available in person (preferable) or by phone.

  • Person doing procedure obtains consent for procedure
  • DTC will obtain consent for sedation

Assure that a family member (person that can consent) is available in person (preferable) or by phone.

  • Person doing procedure obtains consent for procedure
  • Anesthesia will obtain consent for anesthesia
  • Anesthesia will not start anesthesia until consent for procedure is obtained
  • Notify DTC if interpreter is needed
  • Notify DTC if patient is in isolation
  • Notify Anesthesia if interpreter is needed.
  • Notify Anesthesia if patient is in isolation.
 

Once the information is received, Anesthesia or the OR charge nurse will contact requestor about the time for the OR

Questions: 

Contact DTC Coordinator at 2-4402

Questions:

During the week you may contact (in order):

  1. Charge Nurse in AFCH OR at 0-7200
  2. Phone Jim Pleus on cell phone 513-1418, or Tina Gosa 445-7613
  3. Pediatric Anesthesia Attending on-call 712-3517

On the weekends, evenings, and holidays:

  • Call the Main OR AT 3-8595.

Pre-op NPO guidelines for Surgery*

Note that NPO time for Sedation (above) differs from Pre-op NPO time for Surgery (below)*

Children < 2 years old:

Children 2 to 17 years old:

Adults patients >18 years old

Further Hints for Nurses:

  1. IV
    • Check IV patency within 1 hour prior to coming to DTC
    • Replace it on the unit unless an experienced person is unavailable
    • If unable to get access, Place L.M.X.4 to potential IV sites at least 30 minutes prior to arrival to DTC
  2. Patient Medications
    • Patients should be given any medications that are scheduled prior to their sedation appointment, with the possible exception of anti-hypertensive medications. Please hold anti-hypertensive medication if the patient will be sedated within 2 hours of the scheduled medication time.
    • Sedation staff must be informed of any analgesics that have been given to the patient on the day of sedation
  3. Patient Transport
    • Inpatient unit is responsible for patient transport to DTC
    • DTC is responsible for transport back to the inpatient unit
    • Verbal report must be given RN to RN when patient is transferred to and from DTC. The Health Link hand-off form must be completed as well.

revised B. Byrne 1/11/10
revised P. Popic 1/11/10
revised J Fliegel 1/27/10