Non Pharmacologic And Pharmacologic Pain Intervention Flashcards
What is the single most powerful non pharmacological method of pain relief to children
Parents
Non Pharma logical interventions
Reduce perception of pain
Provide sense of control (a traumatic)
Decrease anxiety
Nuances the effectiveness of analgesics
Learn the intervention prior to need
Non pharmacological categories
Sensory
Cognitive behavioral and relaxation
Imagery
Sensory technique
Used to alter the perception of pain by stimulating ones senses
Sight smell taste feeling hearing
Tactile stimulation of cutaneous fibers
May be completed with perceived painful sensations
Distraction stimulation
May refocus attention away from pain
Ex of tactile stimulation
Rubbing stroking patting hugging hand holding
Squeezing a soft object
Vibrating devices
Alternating of heat and cold
Applying transcutaneous electrical nerve stimulation TENS
Cold vibration devices
Buzzy bee
Buzzy bee
Uses cold and vibration
Natural gate control pain relief by confusing the body’s own nerves dulling or eliminating sharp pain
“Use between the brain and the pain “
How can you distract infants and young children
Objects that move or change shape or color (pin wheel kaleidoscopes , videos, magic wands)
Pop up books , seek and find books
Puppets
Rocking
Non nutritive sucking
Music and or singing
Play therapy
Art therapy
Distraction for older children and adolescents
Electronic activities such as video games or televisions
Books/reading
Music and or singing
Art therapy
Aromatherapy
Cognitive behaviorist relaxation techniques
Bubble blowing
Counting (backwards or in patterns or groups)
Deep breathing
Progressive muscle relaxation
Biofeedback
Mindfulness based stress reduction (MSBR)
Guided imagery
A trip, pain switch magic glove
Hypnosis
Story telling and pretending
How can guided imagery be done
In person w clinician or there are several recordings available
Taking a trip
Ask the child where they would like to go , tell them to close their eyes and you guide them to it
Pain switch
Ask child to visualize his or her pain as a light or electrical current and then to describe a switch that can be used to turn off the pain
Magic gloves
Used 3-12 yrs of age
Additional non pharm therapies
Yoga
Thai chi
PT
Massage
Acupuncture
Energy therapies
Aromatherapy
Non opioids
Used in conjunction with opioids require less opioid usage
Mild to moderate pain
Targets the PNS
Ceiling effect
Benefits of using non opioids in conjunction with opioids
Pain control is better achieved through this combination method
Pt will experience few adverse side effects from opioids
most common non opioids
Acetaminophen (Tylenol)
IV acetaminophen (Ofirmev)
Ibuprofen (Motrin , advil)
Opioids
Moderate to severe pain
Targets CNS (resp depression)
No ceiling effect
Most effective opioids
Morphine sulfate (morphine)
Fentanyl citrate ( sublimate)
Hydro morphine hydrochloride (dilaudid)
Fentanyl citrate (sublimaze)
100x more potent than morphine
Hydromorphone hydrocholoride (dilaudid)
6x more potent than morphine
Methadone
Methadone may be used to wean them from opoids and to treat severe or chronic pain
Other opoids
Oxycodone /OxyContin
Hydrocodone combine with acetaminophen or ibuprofen
Oxycodone /OxyContin
“Contin” extend and release