Sedation Medicines in the ICU

Important information:

Sedation medicines are sometimes used for children in the ICU to help keep them relaxed and comfortable. They are most often used for children who require a breathing tube and breathing machine (ventilator) to help them breathe more easily. The most common sedation medicines are fentanyl, midazolam and dexmedetomidine. We give your child these medicines through their IV line. Your child may need these medicines for a short or long amount of time. Some children are more awake on sedation medicines than other children. 

At times, your child may need extra doses of these medicines to help keep calm. The extra doses are called rescue or prn doses. We will watch your child closely to see if they need extra doses of medicine to stay relaxed and comfortable.

How will I know if my child is comfortable?

Nurses will monitor your child’s heart rate, blood pressure, and other vital signs that may tell us that your child is uncomfortable. If your child cries on a breathing machine, you will not hear them because of the breathing tube. Nurses will measure your child’s comfort level using a scoring system. Please talk with the healthcare team if you think your child is having pain or discomfort. 

What can I do to help my child?

• Speak quietly and reassure them

• Hold your child’s hand

• Bring in your child’s favorite toys, books, etc.

• Use a quiet voice to sing or read to your child

• Participate in daily care with the help of your nurse (bath time, diaper changes, repositioning)

• Explain what is happening to your child

• Turn down the lights

• Play your child’s favorite or familiar music

Each child is different. Please partner with your nurse first to decide which of these suggestions may be most helpful.

When will the care team stop using these medicines?

We usually decrease the medicines slowly. If we stop them suddenly, your child could have withdrawal symptoms. If your child has a breathing tube, we need to decrease the medicines before we remove the breathing tube. Your nurse will continue to monitor your child’s comfort and assess for signs of withdrawal as we decrease the medicines.

Please ask your child’s healthcare team about your questions or concerns so that we can work together to provide the best care for your child.

Reviewed March 2024 by Susan Phillips MSN, Amanda Manzi, DNP