PASS is the pediatric sedation service which cares for the "PAIN" of children at
East Tennessee Children's Hospital in Knoxville, Tennessee.
PASS represents not only our company (Pediatric Analgesia & Sedation
Specialists, PLLC) but also our primary mission--
PAIN represents what our service provides for:
P = Pain - minimizing the pain of those painful procedures.
A = Anxiety - lessening the anxiety involved with any procedure.
I = Immobility - keeping children still during tests such as MRI.
N = Napping - enabling a child to sleep for tests like eeg's
So when you put it all together, PASS is a dedicated service that utilizes the
most current sedation techniques to help ease the "PAIN" of children
undergoing procedures at East Tennessee Children’s Hospital (ETCH).
This service is made up of specialized physicians and nurses. Sedation physicians
are provided by PASS, PLLC. Nurses, specifically skilled and trained to work
with pediatric sedation are provided by East Tennessee Children's Hospital.
Each child is assessed based on his/her individual medical needs and the planned
procedure. Infants and children require sedation and pain control for procedures
that older patients may tolerate without sedation. For example, a medical specialist
can’t ask or expect a 2-year-old to remain still for a 45-minute MRI. A teenager
may be able to sit still but may be too anxious to have a spinal tap without medication.
Each of these patients can benefit from the PASS service.
Sedation means a child is given medicine and may or may not be conscious but will be relaxed and breathing on his or her own. When a child is sedated, he/she will better tolerate a medical procedure and will not remember the procedure. If the procedure is painful, medicine to relieve the pain may also be given.
How does it differ from general anesthesia?
Sedation is different from general anesthesia. With general anesthesia, the patient will be completely unconscious and will likely need assistance from a ventilator for breathing.
Is sedation right for every child and every test?
The PASS physicians will evaluate your child prior to the procedure. If your child is or has been sick, an elective procedure may be rescheduled. If the physician has medical concerns about your child being able to be sedated safely, then your child will be referred to Anesthesiology for general anesthesia.
Sedation is also good for minimally invasive or non-invasive tests only. Procedures that require more than two or three hours or involve severe pain are best done under general anesthesia. For example, getting your appendix out requires general anesthesia, but lying still for an MRI can be done with sedation.
Children are better able to deal with the pain of a medical procedure if they are calm and relaxed. Utilizing the most current sedation techniques, the PASS service is able to help children tolerate procedures and not be afraid. If the procedure is painful, medication to relieve pain may also be given.
PASS utilizes newer sedation medications that may be administered only by certain specialists. These newer drugs are more effective and safer than older medications but are administered in a different manner, making it necessary for a doctor solely responsible for sedation to be present. The drugs work quickly and wear off quickly and can also put patients into a deeper state of sedation for a shorter amount of time, enabling the child to be motionless for the test. While any sedation ensures the child doesn’t remember the discomfort of a test, a milder level of sedation would not necessarily keep the child still enough to ensure the most accurate test results.
In the past, the physician performing the test often administered sedation drugs as the test was being conducted. Now, a sedated patient is under the eye of the “sedation doctor,” while a second physician focuses entirely on conducting the test, ensuring a safer test for the child.
There are three different levels of sedation that are defined by the AmericanAcademy of Pediatrics. The PASS physician will discuss the level of sedation that will be required based on the child and the procedure being performed. The following descriptions may also help in understanding sedation:
Minimal Sedation: The patient responds normally to verbal commands. Minimal sedation relieves patient anxiety and is the typical level for cystograms and other minor procedures.
Moderate Sedation: Patients respond to stimulation but may be drowsy. Moderate sedation is a typical level for laceration repair or other minor emergency procedures. Sedation medicine is given by mouth or intravenously depending on the test or procedure. Most EEG’s can be done with medicine by mouth but painful procedures typically require IV sedation medicine.
Deep Sedation: The patient is asleep and lies still but can be aroused by repeated stimulation. Deep sedation is the typical level for MRI, CT Scan, bone marrow tests, spinal taps and other procedures.