Acute Pain in Pediatrics Flashcards
Who cannot self treat for teething?
If experiencing vomiting, diarrhea, malaise, fever, rashes, or if there are eruption cysts present.
Basically, systemic symptoms.
What are eruption cysts?
Dome-shaped, soft, bluish swollen area filled with tissue, fluid and blood.
Refer to dentist if it hasn’t gone away in a week
What signs warrant a dental consult when possible?
Pericoronitis
Delays >6 months in primary tooth eruption
Delays >12 months in permanent tooth eruption
Eruption cysts
What signs warrant a medical consult when possible?
Suspected systemic illness in a young child
What signs warrant an urgent dental consult?
Pericoronal abscess (caused by acute pericoronitis)
What are prevention measures for managing teething?
Wipe gums of infants BID
Brush primary teeth BID
Monitor teeth
No bottles in bed with milk, formula or juice– leads to baby bottle tooth decay
Should have a dentist assessment every 6 months after first tooth comes in
What are some nonpharmacologic therapies for teething?
Rubbing gums
Offer teething rings
Keep it cool (but nothing frozen)
Dry the drool
What are pharmacologic therapies for teething? What’s one ingredient to avoid?
Acetaminophen: 10-15mg/kg/dose, q4-6h prn, max 75mg/kg/day
Ibuprofen: 5-10mg/kg/dose, q6-8h prn, max 40mg/kg/day
Do not use benzocaine– will lead to methemoglobinemia
What should not be used to treat teething?
Drinking alcohol teething biscuits aspirin rubbing oral pain relievers on the gums instead of ingesting them topical anesthetics frozen items
What scales can we use to assess pain in non-verbal children, or those <3?
FLACC Scale: face, legs, activity, cry, consolability Each category is scored from 0-2. 0: relaxed and comfortable 1-3: mild discomfort 4-6: moderate pain 7-10: severe pain, discomfort, or both
What scales can we use to assess pain in young children (3-8)?
Faces pain scale Wong Baker Faces Pain Rating Scale Oucher pain scale Visual analog scales, color analog scale Verbal Numeric Rating Scale
What scales can we use to assess pain in older children (8-11)?
Visual analog tools that rate pain intensity on a horizontal or numeric scale
What scales can we use to assess pain in adolescents?
Numeric rating scale without accessory pain assessment tool
What is normal tooth eruption for primary teeth?
Follows the 7+4 rule:
At 7 months, first tooth
Every 4 months, 4 more teeth should have erupted
Lower central incisor, followed by the teeth next to it, and them mirrored upper teeth
What is normal tooth eruption for secondary dentition?
1st tooth erupts at 6-7 years old, and continues for 6 years
