Pain management in children Flashcards
Longterm effects of unmanaged pain
-Increased distress for later procedures
-Non-adherence to treatments
-development of chronic pain
-memory of pain
Factors influencing pain
-Age/gender
-Cognitive level
-Temperament
-Previous pain experiences
-Family and culture
-Situational factors
Development considerations in infants (physical)
-Facial expressions
-Body movements
-Crying
-Irritability
-Restlessness sleeping
-Poor feedings
Development considerations in infants (physiological)
-Increased heart rate
-Increased BP
-Bradypnea
-Sweating
Development considerations in toddlers
-May react to procedures even if painless
-Emotional: scream, quiet, facial expressions, teeth clenching.
Physical resistances: bit, kick, hit, thrash, run away, hide behind parents
-May point to the pain, may say bobo or ow
-Encourage to verbalize pain
Development considerations in preschoolers
-Become quiet, hide, need to go to the bathroom
-Pain= punishment for being bad
-Will not always say that they have pain
-Description of pain isn’t easy
Development considerations in school age children
-Older than 8 can communicate with more precision
-Might deny pain
-Muscular rigidity
-Stalling behaviours
Development considerations in adolescence
-Concerned about body image and losing control
-Mood and what they think is expected of them
-Ask a lot of questions
-Pay attention to details
-Increased muscle tension, grit teeth, clench fists, increased breathing, guard affected area
What pain scale do we use with children?
EVENDOL
Types of non-pharmaceutical pain management
-Relaxation
-Distraction
-Imagery
-Thought stopping
-Positive self talk
Sucking and sucrose
-Heat and cold
-Massage and pressure
Pharmaceutical managment-non-opiods
-Acetaminophen & NSAIDS (first line agents)
Pharmaceutical management-opiods
For moderate to severe pain
-Morphine, dilaudid
Pain management other
-Local anesthetic applications
-PCA
What could you apply to decrease pain when injections
EMLA
