Peds Pain Mangament

Difficulty identifying pain in pediatric patients

Challenges in recognizing pain in children, consider factors such as gender, culture, and language.

Pain Assessment

Evaluating if a person is in pain based on their behavior during activities like playing, sleeping, or being easily distracted. Also, assessing pain in different age groups.

Signs of Pain

Observable behaviors indicating pain such as pulling on ears, rolling side to side, refusing to move, flushing of skin, vital sign changes, fear, anxiety, sadness, irritability, and crying.

Assessment Approach

Methods for assessing pain including the use of pain scales, vital sign assessment, and concerns related to opioids and respiratory depression.

Pain Scales

Different scales used to assess pain including FLACC, FACES, NRS, Poker Chip Tool, PIPP, and Oucher.

FLACC

Face, Legs, Activity, Cry, Consolability; a pain assessment scale for non-verbal patients and infants to 7 years old.

FACES

A pain assessment scale where the child chooses a face that represents their pain level, suitable for ages 3 to 9, considering cognitive ability.

NRS

Numeric Rating Scale, ranging from 0 to 10, where the child rates their pain level, suitable for 9-year-olds and considering cognitive ability.

Managing Pain Acute

Acutely:Different approaches to managing pain, including the use of non-opioids for mild to moderate pain, opioids like morphine for moderate to severe pain, and avoiding Demerol due to CNS stimulation.

Managing Pain Acute PCA PUMP

Acutely PCA/NCA with Opioid:Comparison between NCA (nurse-controlled analgesia) and PCA (patient-controlled analgesia) for opioid administration, starting PCA use at 5-6 years old, monitoring for side effects like respiratory depression and anaphylaxis.

Managing Pain Sedation

Acutely Conscious Sedation:Using sedation with depressed LOC but intact protective reflexes, potential side effects of different medications like Ketamine, Fentanyl, Versed, and Propofol.

Managing Pain Miscellaneous

Miscellaneous Therapies:Additional pain management options including topical numbing solutions like EMLA/LMX, lidocaine sprays, and the use of sucrose (this is why we give kids lolipops after a doctors visit or shot.

Managing Pain Non-Pharm

Alternative Therapies:Non-medication approaches to pain management such as distraction, preparation, relaxation, room temperature, transcutaneous electrical nerve stimulation (TENS), massage, and acupuncture.

Managing Pain Home Strategies

At Home Strategies for managing pain at home including distraction, controlled breaths, massage, repositioning, medication, and warm/cold compress.