Nonpharm pain interventions
Distraction, play \n Relaxation: holding, rocking \n Guided imagery, breathing \n Positive self-talk \n Behavioral rewards (stickers) \n Swaddling, positioning \n Skin-to-skin (kangaroo care) \n Non-nutritive sucking (NNS) \n Massage \n Biofeedback
Pharm pain intervention
Use least traumatic route \n Routine vs PRN \n Combine adjuvant with analgesia \n • Steroids, antidepressants, anti- \n anxieties, muscle relaxants, \n anticonvulsants \n Analgesics: \n • Acetaminophen & NSAIDs \n • Opioids: morphine, oxycodone, \n fentanyl (mod-severe) \n No IM or intranasal \n Discourage rectal
PEWS pain scale
NIPS
Infant temp
37.5-37.7
axillary, rectal
3-5 yr temp
37.2-37
axillary, tympanic, oral, rectal
7-9 yr temp
36.7-36.8
axillary, tympanic, oral
11-13 yr temp
36.7- 36.6
axillary, tympanic, oral
newborn HR
110-160
infant HR
90-160
1-2 yr HR
80-140
3-5 yr HR
70-120
6-12 yr HR
60-110
13-18 yr HR
50-100
Newborn RR
30-60
irregular
infant to 2 yr RR
25-30
3-5 yr RR
20-25
6-12 yr RR
20-25
13-18 yr RR
16-20
Newborn BP
64/41
Infant BP
85/50
1-2 yr BP
85-91/37-49
3-5 yr BP
89-98/46-53
6-12 yr BP
94-106/55-62
13-18 yr BP
120/80
OLD CAT
Onset
Location
Duration
Character
Aggravating/alleviating
Timing
SODA
Sleep
Output
Diet
Activity