Medical Professional Publications

Sedation before Diagnostic Radiologic Procedures

Radiology Update

(From the August 2014 Issue of MedStat)

At Nationwide Children’s, comprehensive pediatric medical imaging and interventional radiology services are provided 24 hours a day, 7 days a week. Our team of experts specializes in providing medical imaging studies as quickly and as easily as possible. If sedation is required, Anesthesiology provides a full spectrum of sedation from minimal sedation to general anesthesia.

Recently, Radiology has identified an increase in the number of patients arriving for their diagnostic procedures having been prescribed oral sedatives for the purpose of completing the exam by the ordering physician (both inpatient and outpatient). The radiologists, technologists and nursing staff are often unaware that a medication has been administered, what drug was administered, what dose and at what time. This has resulted in injuries to patients in our waiting rooms while awaiting the start of a procedure. It also places the patients at higher risk, particularly in the MRI suite, where direct observation is limited, and raises medicolegal issues for patients who are expected to sign consent for their procedures. Not knowing the patient’s baseline medical status may limit our ability to release the patient to home following completion of the examination/procedure and may require emergency room monitoring or, on occasion, hospital admission.

Prescribing sedative or anxiolytic medications, of any type, with the intent of facilitating a procedure without having sedation privileges, being present for the sedation and/or completing the proper medical documentation, is a violation of the Nationwide Children’s procedural sedation policy (XI-30:50) and poses a safety risk to our patients. Regardless of the intended level of sedation or route of administration, how a given patient — especially those not accustomed to taking sedative medications — reacts is unpredictable. Sedation represents a continuum from mild sedation to general anesthesia. This policy is designed to ensure the provision of one standard for procedural sedation services throughout the institution.

Patients with documented disease processes that require the regular use of medications that may have sedative effects do not fall into this category if the intent of the prescription is treatment of the disease and not procedural sedation.

For patients needing sedation, please make arrangements to have the patient scheduled with the anesthesia department, which is able to provide all levels of sedation.

If you have questions about this policy or about this topic, please contact Greg Bates, MD, at Greg.Bates@NationwideChildrens.org or Josh Uffman, MD, at Joshua.Uffman@NationwideChildrens.org.

Nationwide Children's Hospital
700 Children's Drive Columbus, Ohio 43205 614.722.2000