Patients will have pre-medication administered to assist with completion of relatively short,
pain free diagnostic tests and/or procedures (such as CAT scan, ultrasonography, EEG,
limited MRI). This policy is not intended for use for patients requiring conscious sedation
(see Administrative Policy & Procedure PC:0017).
Patients excluded from this policy include the following:
SCOPE: Registered nurses, licensed practical nurses, nursing assistants, medical staff
A. Patient will have baseline weight (in kilograms), heart rate, blood pressure and pulse
oximetry taken and recorded prior to administration of pre-medication. These values must be within normal limits.
B. The proper dose of pre-medication will be administered and recorded as per nursing
policy. Noted problems related to administration (vomiting, spitting up, refusal) will be
documented and the ordering physician made aware.
The following recommended starting and follow-up doses are recommended. These doses
are meant to be guidelines and may vary per individual patient and ordering physician.
Medication Initial Dose Subsequent Dose
Chloral Hydrate 75mg/kg PO/PR 25mg/kg PO/PR after
Secobarbital 3mg/kg IM 2mg/kg IM after
30- 45 minutes
Pentobarbital 5mg/kg/IM 1mg/kg IM after 30- 45
Intranasal 0.2 – 0.4 mg/kg
C. If the patient is fully awake and coherent 45 minutes after successfully being given the
first sedative, the ordering physician should be contacted and a subsequent
dose may be given per the above guidelines.
D. The patient will be transported to the appropriate diagnostic area by a clinical assistant.
An RN and/or MD must accompany the child if the individual child’s level of
monitoring warrants. Monitoring (such as continuous pulse oximetry,
frequent vital signs, or cardiac monitoring) may be ordered by the physician as
E. Upon completion of the diagnostic test, the patient will be accompanied by the
RN/NA/MD back to the inpatient unit.
F. The patient will be assessed by the RN upon return to the unit until fully awake and