Ear Center: Pediatric Sedation for Auditory Brainstem Response Testing

Information for Pediatric Sedation

The Ear Center of Greensboro, PA, follows guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic purposes as outlined by the American Academy of Pediatrics (1992 and 2002). Because of these guidelines, pediatric patients requiring sedation for ABR's are scheduled for their ABR testing at the Moses Cone Hospital that is located across the street from The Ear Center.

All pediatric patients must be accompanied to and from the hospital by a parent or legal guardian.

On the day of your child's test at the hospital, please arrive on time. If you arrive more than 10 minutes late, the test may need to be rescheduled. Pediatric sedation at the hospital requires the coordination of several different departments and specialists.

Objectives
The test being performed is an ABR/ASSR, Auditory Brainstem Response/Auditory Steady State Response, which evaluates the activity of the hearing nerve in response to sound stimulation. Using a computer, the ears are stimulated with sound that travels through the ear and the hearing nerve into the brain. The nerve activity from ears with hearing loss does not appear as strong or as clear as normal hearing nerve activity. Electrodes are taped to the head, and small insert earphones are placed in the child's ears so clicking sounds may be presented to each ear. Total test time, after the child is asleep, varies between 20 and 90 minutes.

Sedation
Sedation is performed with a variety of different sedatives. These include medications such as Chloral Hydrate and Benadryl (both may be given in syrup form) and medications such as Versed® (may be given orally as a syrup, IV, or intranasally).

It is important that your child remains still during the testing. The audiologist will be able to obtain more accurate results when sedation is utilized. It is important that your child be taken to the hospital tired and/or sleepy. Please keep your child up late the evening before and awaken him/her early in the morning of the test. The goal of sedation is to achieve the best test results possible by controlling your child's behavior and level of muscle activity.

Instructions for limitations of activities and appropriate dietary precautions:

Intake of food and liquid should be as follows:

  1. infants 0 to 5 months: no milk or solids for 4 hours before scheduled procedure,
  2. infants 6 to 36 months: no milk or solids for 6 hours before procedure,
  3. children older than 36 months: no milk or solids for 8 hours before procedure.

Your child may have clear liquids until 2 hours before the procedure. Sedative medication cannot be administered at home.

Once you arrive at the hospital, a doctor or nurse will administer the medications to your child. It is important not to bring other children or family members with you to the hospital as an extremely quiet environment is essential to the accuracy of the test. After the test is completed, your child may be tired and somewhat clumsy for the remainder of the day. Parents should arrange to observe their children closely, particularly around stairs. Do not leave your child unattended, even if he/she appears to be asleep. Your child will not be discharged from the hospital until he/she returns to a safe state of awareness.

Risks involved with sedation include: vomiting, seizures, allergic reactions (anaphylaxis or anaphylactoid reactions), decreased breathing (hypoventilation), cessation of breathing (apnea), airway obstruction, cardiopulmonary impairment, and death. Management of these risks may include ventilation by mask and/or cardiopulmonary resuscitation (CPR) performed by trained hospital personnel.

Test Results

Results will not be available for several days after the test in order to allow time for analysis, preparation of a report,
and review by your physician. Test results will not be available on the day of testing.

ABR testing is usually covered by most insurance plans. It is always a good idea to check with your insurance provider to make certain that the testing is a covered expense as defined by the terms of your current policy.

If you have any questions concerning pediatric ABR testing, please call us at (336) 273-9932 and ask for the Audiology Department.

Last updated 11/17/2010