2024 Comfort Measures

Comfort Measures to make us the best!

What is the 2024 Cardinal Goal?

Comfort Measures! Making sure our Cardinal Kid has a pain free visit

Landmarks

Physical places on the body to look for so we know we are giving shots  in the correct location.

Anterolateral​

Anterior and lateral position situated in the front and to the side​

Greater Trochanter

A bony prominence at the top of the femur where the hip and thigh muscles are fixed​

Is a strep swab a big deal? I do 20 of them a day

YES!! Its a big deal to that ONE CHILD. COMFORT COMFORT COMFORT!I

What is Vaxelis

DTaP + IPV + Hib + HepB

How is Vaxelis Given

IM

What is in PROQUAD

MMRV - Measles, Mumps, Rubella, AND Varicella (SQ);

How is PROQUAD given

Sub Q

What is Kinrix?What i

DTaP-IPV

How is Kinrix given?

IM

What is in Infanix

DTaP

How is Infanrix Given?

IM

What is in DTaP

diptheria, tetanus, pertussis (whooping cough)

What is in IPV

inactivated polio vaccine;

How is IPV given

IM

What is in Hibrix

HIB: Haemophilus influenzae type B;

How is HIB given

IM

How is HIBRIX given

IM

What is in Vaxneuvance

pneumococcal conjugate vaccine (15-valent);

How is Vaxneuvance given

IM

What is Hepatitis B

inflammation of the liver caused by the hepatitis B virus (HBV), which is transmitted sexually or by exposure to contaminated blood or body fluids;

How is Hep B given

IM

What is Hep A

inflammation of the liver caused by the hepatitis A virus (HAV), usually transmitted orally through fecal contamination of food or water;

What is Havrix

Hep A

How is Havrix Given

IM

What is MMR

measles, mumps, rubella

How is MMR Given

Sub Q

What is Varicella

Chicken Pox

How is Varicella Given

Sub Q

What is Rotateq

rotavirus 5 vaccine

What is Rotavirus

a GI disease causing diarrhea and vomiting

How is Rotateq given

orally

What is in Boostrix

TDaP: Tetanus, Diphtheria, Pertussis Vaccine

How is Boostrix Given

IM

What is the difference between Tdap and DTaP

DTaP is under age 7. Tdap offers continued protection - typically at 11.

What is Menveo

Meningococcal vaccine that protects against 4 strains of meningitis;

How is Menveo Given

IM

What is Bexsero

MenB vaccine

How is Bexsero Given

IM

What is Gardisil

Human Papillomavirus (HPV) vaccine

What is HPV

a viral infection that commonly causes skin or mucous membrane growths (warts)

What are the 2month vaccines

Vaxelis, Vaxneuvance, and Rotateq

What are the 4 month vaccines

Vaxelis, Vaxneuvance, and Rotateq

What are the 6 month vaccines

Vaxelis, Vaxneuvance, and Rotateq

What are the 12 month vaccines and procedures

Havirix (Hep A) and ProQuad (MMRV); Lead and Hgb (finger stick)

What are the 15 month vaccines

Infanrix (DTaP), Hiberix (HiB), and Vaxneuvance (PCV-15)

What are the 18 month vaccines

Havrix (Hep A) (has to be 6 months from the previous Hep A vaccine)

How far apart do does of HepA have to be?

6 months

What do we do for a 24 month visit?

Lead and Hgb

What are the 4 year old Vaccines

Kinrix (DTaP-IPV) and ProQuad (MMRV)

What do we want to give at 9 and/or 10

Gardasil (HPV)

What are the 11-12 Year old Vaccines and Procedures

Boostrix (TDaP) and Menveo (Meningitis - MCV4); Total Cholesterol and HDL finger stick

What are the 16 year vaccines

Menveo (Meningitis - MCV4) and Bexsero (Meningitis B)

What two vaccines should NEVER be given in the same extremity (i.e. the same arm, same leg)?,

Pneumococcal and Influenza Vaccine; it can cause necrosis.

What vaccines are given subcutaneously (SQ)?

MMR, Varicella, and MMRV (Proquad)

Which vaccine is given orally?

Rotateq

How do you landmark the for an IM injection on the leg

How to Landmark​

1. Position the patient lying down or held by a parent​

2. Palpate the muscle below the great trochanter ​
   and above the lateral femoral condyte (knee joint)​

3. Divide the muscle into thirds​

4. Administer the injection into the MIDDLE THIRD of the muscle, in the outer anterolateral aspect, lateral to the midpoint of the thigh

How to landmark Fatty Tissure on back of Tricep

• Locate Acromion process​

• Bony prominence above deltoid​

• Locate Elbow​

• Go between the two​

• Make sure you PINCH up on the sub q tissue to prevent muscle injection​I

Sub Q injection given at what angle

45

What are the landmarks for a shot in the arm?

How to Landmark​

1. Patient sitting comfortably with the arm visable from the shoulder to the top of the elbow​

2. Papate the acromion (outer age of the scapula) and trace an imaginary inverted triage below the shoulder​

3. Inject in middle of triangle

What is a Buzzy Bee - how do I use it

Block the pain recepters

How many seconds for a Buzzy Bee?

30-60 for a normal immunization, 90-120 for HPV

How long do you spray Freeze spray

Just until its cold -not until its white!! Give it time to work

Do I really have to give our popsciles?

Yes - Give out FULL popsciles after asking parent. Think about them with swabs and just anytime someone is having a bad day. Get parental permission

What is a comfort measure for Lead draws or other finger sticks

HEAT!!! Heat gets the blood flowers so makes for easier. Feel free to use 2 comfort measures at this time Have them blow on a pin wheel, while holding a warming device. Also think about giving kids fidget things to keep their hands working and loose.

Name the 6 different comfort holds and be ready to demonstrate them.

• Cuddle Hold infants​

• Side comfort Hold infant/toddler​

• Chest to Chest​

• Back to Chest​

• Side Comfort hold ​

• Side by Side comfort hold'​