Informed Consent for Oral Sedation before an Echocardiogram (ECHO)

Pain and Sedation Service

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Informed Consent for Oral Sedation before an Echocardiogram Leaflet PIAG 303 (213kB)

General information

An echocardiogram, or “echo” is a type of ultrasound scan. This scan is used to look at the heart and nearby blood vessels.

A handheld scanner is placed on the chest and stomach and gives a picture of the heart on a TV monitor. Your child will feel some pressure as the scanner is pushed quite firmly. It is not painful but may be a bit uncomfortable.

In most cases you will be able to stay with your child during the echo, and provide comfort and support.

Because your child must lie very still for this scan, sometimes they are given some oral sedation (medicine to make them feel calm or sleepy). This is usually a liquid medicine, given as a drink. There are no needles involved.

Your child does not need to be starved to have oral sedation.

If your child gets very upset during procedures the alternatives are to be given longer acting, more powerful sedative drugs or a general anaesthetic. Both of these options will require your child to undergo a period of starvation and they may spend much longer at the hospital.

Staff will monitor your child’s oxygen levels using an oxygen measuring probe on a finger or toe, if your child falls asleep. Both sedation and general anaesthetics are associated with a small risk of harm.

Sometimes children become too sleepy and need extra oxygen through a mask or breathing tube.
Occasionally, the sedation may not work properly and extra medicine or treatment needs to be given.
Children may feel the need to vomit when they have been given sedation. Very rarely, children may breathe vomit into their lungs while they are sedated (aspiration). Staff will treat your child if this happens.

Sometimes children become too sleepy and need extra oxygen through a mask or breathing tube.
Occasionally, the sedation may not work properly and extra medicine or treatment needs to be given.
Children may feel the need to vomit when they have been given sedation. Very rarely, children may breathe vomit into their lungs while they are sedated (aspiration). Staff will treat your child if this happens.

If you agree to your child having oral sedation, and if you have any questions, please tell the person who gave you this leaflet.

Types of sedation medicine

Sedation is when a type of medicine called a sedative is given to children to help them feel calm or sleepy. The following medicines are the most common sedatives used in children having echos. Not all sedation medicines suit all children. The nurse or doctor will assess your child and tell you which one of these medicines your child can have.

Midazolam

Midazolam is a benzodiazepine medication. Benzodiazepine medications have calming effects.

Midazolam will make your child sleepy but does not provide pain relief.
It is a liquid medicine, given as a drink.
Some children may become hyperactive instead of relaxed after they have the midazolam. If this happens, a different drug may be needed or the procedure will need to be rescheduled.
Your child may not remember the procedure.

Chloral hydrate

Chloral hydrate is a sedative medication that makes children drowsy, and it is useful where a child needs to be very still for 20–60 minutes.

Chloral hydrate is a liquid medicine, given as a drink.
Chloral hydrate is also available as a suppository, which is placed in your child’s bottom.
It can take from 10 to 30 minutes for your child to become drowsy.
Before the appointment try to keep your child awake as much as possible, as this helps the drug to be more effective.
The effects wear off quickly.

This leaflet only gives general information. You must always discuss the individual treatment of your child with the appropriate member of staff. Do not rely on this leaflet alone for information about your child’s treatment.

This information can be made available in other languages and formats if requested.