4.6 Pain Flashcards
When should validated pain scales be used in the peds population
in any situation where pain can be anticipated
What can be helpful for infants under 3 months for pain management for short painful procedures like vaccinations
sucrose water
What timing should be used for administering sucrose for procedural pain
Give part of the dose 2 minutes before the procedure and the rest during the procedure
Is premedication with tylenol or ibuprofen helpful for infants prior to immunizations
no
What can be used to help with pain in those over 6 months before immunizations
topical anesthetic
like lidocaine applied 30 mins before IV is put in
What can be used sparingly for teething pain or when tongue tie is cut
topical liquids like orajel
What can be done to treat pain after procedures or pain associated with illness
ibuprofen or acetaminophen
dose based on weight
What three approaches should be combined to minimze pain and distress from medical procedures done to infants and kids
3-Ps
phsycial, psychological, and pharmacological
If a child must be restrained for a procedure what is more comfortable than being restrained laying flat on the bed
sitting up- can be on caregivers lap
Secure, comforting, or ‘hugging’ holds serve to assist, rather than restrain, the child
family presence should always be encouraged
What can infants do while undergoing procedures to help with comfort
breastfeeding
Breastfeeding can be a multimodal comfort strategy, simultaneously offering skin-to-skin contact, the comfort of sucking and rocking, and (likely) the transfer of endogenous opiates in breast milk
What physical strategies can be done to reduce pain in infants during procedures
3
- pacifier use (non-nutritive sucking)
- skin to skin
- swaddling
FYI
Choosing less painful approaches
When a less painful option is available, avoiding certain painful procedures, such as heel lances and IM injections, is recommended. Since heel lancing is more painful than venipuncture, with or without sucrose, heel lances should be avoided. When venipuncture performed by an experienced phlebotomist is compared with heel lancing, the number needed to treat to avoid repeat skin puncture is three. Moreover, when both an IV insertion and blood tests are required, they should be done at the same time, whenever possible. Daily bloodwork should not be prescribed in an automatic, routine fashion. If this is required for special or critical situations, it should be restricted to a short period of time and reassessed daily. Grouping bloodwork is also important.
What can kids over age 4 benefit from in terms of psychological prep before a procedure
simple info regarding what to expect
Explaining the steps of a procedure, receiving sensory information about what they might feel (e.g., cold, wet), seeing the medical supplies that will be used, and offering realistic choices or roles related to the procedure helps children to feel more in control
What should parents avoid telling children before a procedure
false reassurances like:
it wont hurt
its all over
this is the last stitich
Why should the provider avoid saying “I’m sorry” during a procedure
it can confuse the child
