Journal article
PAIN IN THE PEDIATRIC INTENSIVE CARE UNIT: HOW AND WHAT ARE WE DOING?
American journal of critical care, Vol.28(4), pp.265-273
07/01/2019
DOI: 10.4037/ajcc2019836
PMID: 31263009
Abstract
Background Pain management in critically ill children is complex. Epidemiological research is needed to identify how often patients in pediatric intensive care units experience pain and the practices being used to lessen pain.
Objectives To describe pain assessment and intervention practices in pediatric intensive care units, determine the prevalence of pain and painful procedures, and identify characteristics of children with moderate to severe pain.
Methods A 24-hour observational cohort study was conducted in 15 units. Nurses completed surveys regarding patients' communicative ability. Patients' records were reviewed for pain assessments, painful procedures, and pharmacologic and nonpharmacologic interventions.
Results For the 220 patients in this study, pain was assessed a median (interquartile range) of 10 (7-13) times, usually with behavioral pain scales. Sixty-eight percent of patients received pharmacologic interventions and 44% received nonpharmacologic interventions. Fentanyl was the most common analgesic provided. Repositioning was the most common nonpharmacologic intervention. Forty-five percent of patients had pain and 24% had moderate to severe pain. Patients experienced a median (interquartile range) of 7 (2-15) painful procedures in 24 hours. More frequent pain assessments and pharmacologic interventions and the ability to communicate were associated with moderate to severe pain. No patient in the moderate to severe pain category received neuromuscular blockers.
Conclusions Critically ill children experience pain and multiple painful procedures daily. Assessment and intervention practices vary considerably. Research is needed to establish best practices for pain assessment in patients with limited communicative ability and to determine which pain management strategies improve patients' outcomes.
Details
- Title: Subtitle
- PAIN IN THE PEDIATRIC INTENSIVE CARE UNIT: HOW AND WHAT ARE WE DOING?
- Creators
- Cynthia M. LaFond - University of ChicagoKirsten S. Hanrahan - University of IowaNicole L. Pierce - University of ChicagoYelena Perkhounkova - Univ Iowa, Coll Nursing, Iowa City, IA 52242 USAElyse L. Laures - University of IowaAnn Marie McCarthy - University of Iowa
- Resource Type
- Journal article
- Publication Details
- American journal of critical care, Vol.28(4), pp.265-273
- Publisher
- Amer Assoc Critical Care Nurses
- DOI
- 10.4037/ajcc2019836
- PMID
- 31263009
- ISSN
- 1062-3264
- eISSN
- 1937-710X
- Number of pages
- 9
- Grant note
- T32 NR011147 / Pain and Associated Symptoms: Nurse Research Training grant from the National Institutes of Health T32NR011147 / NATIONAL INSTITUTE OF NURSING RESEARCH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Nursing Research (NINR) Mayday Fund
- Language
- English
- Date published
- 07/01/2019
- Academic Unit
- Stead Family Department of Pediatrics; Nursing; Community and Behavioral Health
- Record Identifier
- 9984370659202771
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