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SD3 > Paediatric Pain > Flashcards

Paediatric Pain Flashcards

1
Q

Pain Mgx as per SD3

A
  1. RR
  2. Position - POC
  3. MICA ? - Unwell Patient
  4. Pain relief - Paracetamol/Fentanyl IN, Methoxy
  5. Antiemetic - Ondans 2/4mg
  6. MICA up/downgrade/cancel/sitrep
  7. Extrication - wheelchair to stretcher
  8. Reassess VSS 10/60
  9. Load Signal ? MICA ?
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2
Q

Parietal Pain

A

Parietal pain is caused by irritation of the peritoneal lining that surrounds the abdominal cavity.

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3
Q

Visceral Pain

A

Visceral pain is pain related to the internal organs in the midline of the body

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4
Q

Somatic Pain

A

Somatic is generally described as musculoskeletal pain. It occurs when pain receptors in tissues (including the skin, muscles, skeleton, joints, and connective tissues) are activated.

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5
Q

Methoxyflurane Mode of Action

A

Inhaled anaesthetic – produces analgesia at low concentrations, however the exact mode of
action is unknown

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6
Q

Methoxyflurane Indications

A

Analgesia

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7
Q

Methoxyflurane Contraindications

A

Pre-existing renal disease
Known (or genetic susceptibility) to malignant hyperthermia

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8
Q

Methoxyflurane Precautions

A

Patients should not be administered > 6 mL of methoxyflurane in a 24 hour period, due to increased risk of nephrotoxicity

To limit occupational exposure, methoxyflurane should not be administered in a confined space. Ensure adequate ventilation in ambulance. Place used Penthrox inhalers in a closed plastic bag when not in use.

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9
Q

Methoxyflurane Adverse Effects

A

CNS: Dizziness, drowsiness
CV: Hypotension
GIT: Nausea and vomiting

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10
Q

Methoxyflurane Onset/Duration Times

A

Onset of action: Within 6 to 10 breaths

Duration of action: Effects last 3-5 minutes after stopping the inhalation. One vial provides up to 25 minutes of analgesia with continuous use

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11
Q

Paracetamol Pharmacology

A

Analgesic and antipyretic – exact mechanism of action is unclear; thought to inhibit prostaglandin synthesis in the CNS

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12
Q

Paracetamol Indications

A

Mild pain, or pain relief in combination with other analgesics
Headache

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13
Q

Paracetamol Contraindications

A

Children < 1 month of age

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14
Q

Paracetamol Precautions

A

Hepatotoxicity can occur with overdose. Do not administer if paracetamol has already been given within past 4 hours, or if total paracetamol intake within past 24 hours exceeds 4g (adults) or 60 mg/kg (children)

Risk of hepatotoxicity is increased in the following circumstances:
- Impaired hepatic function or liver disease
- Elderly / frail patients
- Malnourishment

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15
Q

Paracetamol Adverse Effects

A

Hypersensitivity reactions including severe skin rashes (rare)
Haematological reactions (rare)
Hypotension has been reported with IV infusion, particularly in critically ill patients

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16
Q

Paracetamol Onset and Duration Times

A

Onset of action: 30 minutes (oral), 5-10 minutes (IV)
Duration of action: 4 hours

17
Q

Fentanyl Pharmacology

A

A synthetic opioid analgesic
Actions:
CNS effects:
- Depression – leading to analgesia
- Respiratory depression – leading to apnoea
- Dependence (addiction)
Cardiovascular effects:
- Decreases conduction velocity through the A-V node

18
Q

Fentanyl Indications

A
  1. Sedation to facilitate intubation (RSI - modified or Paediatric IFS)
  2. Sedation to maintain intubation
  3. Sedation to facilitate transthoracic pacing
  4. Sedation to facilitate synchronised cardioversion
  5. CPR interfering patient - ALS
  6. Analgesia – IV/IN
    - History of hypersensitivity or allergy to morphine
    - Known renal impairment / failure
    - Short duration of action desirable
    - Hypotension
    - Nausea and/or vomiting
    - Severe headache
19
Q

Fentanyl Contraindications

A
  1. History of hypersensitivity
  2. Late second stage of labour
20
Q

Fentanyl Precautions

A
  1. Elderly/frail patients
  2. Impaired hepatic function
  3. Respiratory depression, e.g. COPD
  4. Current asthma
  5. Patients on monoamine oxidase inhibitors
  6. Known addiction to opioids
  7. Rhinitis, rhinorrhea or facial trauma (IN route)
21
Q

Fentanyl Side Effects

A

Respiratory depression
Apnoea
Rigidity of the diaphragm and intercostal muscles
Bradycardia

22
Q

Fentanyl Onset/Duration/Peak times

A

IV effects:
Onset: Immediate
Peak: < 5 minutes
Duration: 30 - 60 minutes

IN effects:
Peak: 2 minutes

23
Q

Different Types of Pain Scales

A

FLACC
Faces Pain Scale - Wong Baker
Verbal Pain Scale

SD3 (13 decks)

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