Your child is having an echocardiogram under sedation

Echocardiograms (Echo) are one of the most frequently used scans for diagnosing heart problems. An Echo is an ultrasound scan of the heart. As your child will need to lie very still for the scan, we may suggest that they have sedation to help. This information sheet from Great Ormond Street Hospital (GOSH) explains about echocardiograms, what is involved and what to expect when your child has the scan.

An echocardiogram (Echo) lets us evaluate the structure, function and blood flow through the heart.

While other scans such as x-rays, CT scans and MRI scans can show the structure of your child’s heart, an Echo is the best way to show it working.

Having an Echo can also avoid the need for other diagnostic tests, such as cardiac catheterisation and angiography that are invasive or other scans, such as MRI or CT scans that might need to be carried out under general anaesthetic.

Some children find it difficult to lie still for the scan – either because of their age or their medical condition – so we might suggest they have sedation for the echo.

We assess all children to see if they might benefit from sedation. Your appointment letter will state whether your child is having sedation so you can follow the instructions below to prepare them.

If you are unable to keep this appointment, please inform the department as soon as possible beforehand. Sometimes, we can offer the appointment to another child on the waiting list.

As so many children and young people need to use our services, we have had to introduce a policy where if a child cancels or does not attend two appointments in a row, we will close their referral and inform their GOSH consultant.

On the day of the scan, wake your child at least one hour earlier than usual and try to keep them awake on the way to GOSH.

It is important that your child does not eat or drink anything for a few hours before the sedation. This reduces the risk of stomach contents entering the lungs during and after the procedure.

You will be informed the night before the procedure of the time that your child should be ‘nil by mouth’ – in other words, have nothing to eat or drink before the sedation. It is equally important to keep giving your child
food and drink until those times to ensure they are not thirsty or hungry. This may involve waking your child in the night to give them a drink which we recommend.

The person bringing your child to the scan should have ‘Parental Responsibility’ for them. Parental Responsibility refers to the individual who has legal rights, responsibilities, duties, power and authority to make decisions for a child. If the person bringing your child does not have Parental
Responsibility, we may have to cancel the scan.

When you arrive at the hospital, you should report to Walrus Ward.

You are welcome to stay with your child throughout the sedation and echo scan. Your child will be admitted to the unit where they.will be seen by a doctor and nurse on the ward. We will ask you to give permission for the echo under sedation by signing a consent form.

Your child will have the sedation medicine as a liquid to swallow 20 to 45 minutes before the scan is scheduled.

Your child will lie on a bed next to the echo machine. The scan can last from 20 to 60 minutes. This will usually give us enough information to plan your child’s treatment. Echo scans are just one part of a series of tests that allow the doctor to monitor your child’s heart and plan treatment.

When the echo has been completed, your child will be able to stay in their bed while they recover. You should be prepared to stay in the hospital until your child is fully awake and has had something to eat and drink. Most children are able to go home a couple of hours or so after the scan.

There are no risks associated with an echo scan. The gel used causes no harm and the echo itself is painless with no lasting effects. The echo uses sound waves rather than radiation to form the pictures.

Chloral hydrate – This promotes sedation and sleep by acting on certain areas of the brain. It is given orally. Possible side effects include: slow breathing rate, vomiting, irritability and prolonged sleepiness.

When your child has recovered fully from the sedation and has had something to eat and drink, you will be able to go home.

A cardiologist will send a report about the scan to your child’s doctor in time for your next appointment. If you have not been given a follow up appointment to see your consultant, please contact their secretary after two weeks.

• Children are generally sleepier than usual for 24 hours after a scan with sedation. This is because the effects of the sedative last for about a day. Let your child rest and sleep for the rest of the day.
• If your child complains of feeling dizzy or faint, basic first aid is usually helpful:
• Sit them down and put their head between their knees or
• Lie them down with their legs raised
• Offer them a sugary drink
• If your child is unduly sleepy or difficult to rouse, make sure they are in a safe position on their side and telephone your family doctor (GP).
• Make sure that your child can tolerate a juice drink before offering anything to eat. Give milk only if your child does not feel sick or has vomited.
• Your child may have mood changes which can make them irritable. This is temporary.
• Keep a close watch on your child until they are back to normal. Do not leave them with an inexperienced carer.
• If your child is taking any medications, please give this as normal.
• Your child should be well enough to go to school the following day.