Recommendations for preparing children and adolescents for invasive cardiac procedures: a statement from the American Heart Association Pediatric Nursing Subcommittee of the Council on Cardiovascular Nursing in collaboration with the Council on Cardiovascular Diseases of the Young.

Staged surgical repair and interventional cardiac catheterization have contributed to improved outcomes for children with congenital heart disease. As a result, there are increasing numbers of children and adolescents who must undergo multiple invasive cardiac procedures at various developmental stages. During these procedures, management of pain and anxiety using nonpharmacological methods is especially important, given the limitation in the types of medications that can be used and the potential for side effects with larger dosages. In addition, children may be particularly vulnerable to the stress associated with invasive medical procedures; several studies document frequent and persistent severe distress reactions after aversive hospital experiences.1–6 Although numerous studies document the efficacy of psychological preprocedure preparation for children and adolescents,7–12 implementation of these interventions remains inconsistent.13 The following guidelines, based on review of the literature and expert consensus, were developed to facilitate systematic implementation of preprocedure preparation for pediatric patients undergoing invasive cardiac procedures.