Pediatric Computed Tomography (CT)
What is Computed Tomography (CT)?
Computer Tomography (CT or CAT scan) is a round machine with an opening in the middle that utilize x-rays to produce pictures of the patient’s body.
What to expect when doing a CT scan?
Before the Exam:
During scheduling, any special instructions will be given to the parents. The need for sedation or anesthesia will also be discussed.
If the exam is performed with anesthesia, the child may be asked not to eat or drink for hours before the exam. This instruction will be given during scheduling and are included at the end of this document.
If your child does NOT need sedation or anesthesia to complete the CT scan, you and your child will come to the radiology department at least 15 minutes prior to the scheduled time. If you child does need sedation or anesthesia a nurse will call you 1-3 days before the appointment with fasting instructions. You will be asked to arrive 60-90 minutes before the scheduled study and sent to the Children’s Sedation and Surgery Center after checking in through registration.
Most CT exams require intravenous (IV) dye (contrast). Contrast helps highlight important body parts needed for an accurate diagnosis. IV contrast is not harmful to children with normal renal function. Minimal pain may be felt during the insertion of the IV. If your child needs help getting through the IV insertion, child life specialists may be able to help with distractions and other techniques.
Some CT exams of the abdomen and pelvis will also require oral contrast. For these exams, the child will need to drink the contrast material several minutes before the exam. The contrast material is not harmful to your child and will help highlight important structures (such as the child’s bowel), helping the radiology doctors to achieve the correct diagnosis. If sedation or anesthesia is needed for this study, additional instructions will be given.
During the Exam:
The child will be asked to put on a hospital gown. Parents may accompany the patient in the room while using a lead gown if NO sedation or anesthesia is needed.
The body part of the patient to be imaged (head, neck, chest, abdomen, arms, legs etc) will enter the machine’s opening during the exam. The machine opening is large and does not touch or hurt the patient.
These exams usually only take a few seconds. It is important for the patient not to move during the exam so the best pictures can be taken. If necessary, the child can be given medication (sedation or general anesthesia) by our nationally recognized Pediatric Sedation Service to be able to complete the exam without moving.
After the Exam:
After the exam is completed and performed without sedation or anesthesia, the child may go home or to the next appointment. If the exam was performed with sedation or anesthesia, the child will be observed in a separate room until the child is fully awake.
- Our trained radiologists will review the images on a computer and provide a radiology report. The report will be available on the child’s medical record and reviewed by the ordering physician.
Additional information can be found at:
https://www.radiologyinfo.org/en/for-kids
https://www.imagegentlyparents.org
If your child requires sedation or anesthesia, please review the following:
The Day Before Your Child’s Procedure
IS YOUR CHILD READY?
- If your child has a fever, runny nose, cough or sore throat, please call the sedation nurses at 984-974-6732.
- Remove any piercings and jewelry from your child.
ARE YOU READY?
- Do not bring anyone who has a cold or who is not feeling well.
- Please try not to bring other children with you because children will have to be supervised by you at all times.
Eating and Drinking Instructions
NPO GUIDELINES
Your child’s stomach must be completely empty when the procedure starts. This is to prevent serious problems during the procedure. Follow the eating and drinking instructions carefully. If you do not follow these instructions, the procedure may be cancelled or delayed.
NO food after MIDNIGHT the night before surgery.
- No solid foods including gum, candy, broth or jello after midnight
- Formula, milk, breastmilk and clear liquids are allowed until the times below
6 hours before arrival time: ____________________________
- Stop cow’s milk and formula 6 hours before arrival
- Only clear fluids (water, apple juice, gatorade, soda) and breastmilk are allowed until 4 hours before arrival
- Do not add thickeners or additives to any liquids
4 hours before arrival time: ____________________________
- Stop breastfeeding 4 hours before arrival
- Only clear liquids are allowed (no thickeners or additives) until 2 hours before arrival
2 hours before arrival time: ____________________________
- Absolutely nothing by mouth from this time
- Handy hint: check the floor, the car and bags nearby for any food or drink that your child could reach
What is sedation?
Providing sedation means a child is given medicine to make the child more relaxed. When a child is sedated, he/she will better tolerate a medical procedure and will probably not remember the procedure. If the procedure is painful, medicine to relieve the pain may also be given. Depending upon the level of sedation, the child may be conscious and able to talk to us or may be deeply asleep but still breathing on their own.
Anesthesia
‘Anesthesia’ refers to medications we give your child to make sure that he/she is deeply asleep during the procedure. Anesthesia is different from sedation and will be provided by pediatric anesthesia doctors.
WHO GIVES ANESTHESIA/SEDATION?
At UNC we have a Nationally recognized Center of Excellence Sedation Service. The team includes physicians (pediatric anesthesiologists and residents), nurse practitioners, nurse anesthetists, pediatric sedation nurses, child life specialist and others to safely care for your child during their procedure.
WAITING AREA
During the procedure, you will be asked to wait in our waiting room. We will update you about your child and let you know when procedure is complete. After the procedure you’ll join your child in our recovery room.
When Can My Child Go Home after Anesthesia/Sedation?
Every child is unique and takes a different amount of time to wake up from anesthesia/sedation.
Your child will need to meet these basic criteria before leaving:
- Awake, or easily roused
- Breathing well
- Pain level is adequately controlled
Discharge Instructions
Before leaving the hospital, your nurse will go over some instructions with you to help you look after your child at home.
These may include:
- What to eat or drink
- How to manage your child’s pain, if applicable
- When to call your doctor
Activities for after sedation often include the following:
- Please follow the directions from your hospital and ask if you have any questions
- Your child will be drowsy after the procedure. How long this lasts will depend on the medication your child receives. The sedation nurse will inform you of what to expect based on your child, the medication they received and the procedure they had done.
- We would advise, if possible, that two adults be with the child to drive home. One adult to drive and one to sit next to the child to make sure they do not become nauseous or fall asleep in an awkward position.
- A child may be unsteady when walking or crawling and will need protection against injury. An ADULT must be nearby at all times until the child is fully awake.
- Older children should rest in an area where an adult can supervise. Escort the child when walking (such as when going to the bathroom).
- A child should not be allowed to perform dangerous activities, such as riding bikes, playing outside, etc., until back to a normal state of awareness.
- We advise you against taking children to daycare following a procedure. He/she may return to normal activities on the day after the procedure, once the child has returned to a usual state of alertness and coordination.
- Follow all discharge instructions given to you by your child’s nurse.