Journal article
Pain Assessment and Management for a Chemically Paralyzed Child Receiving Mechanical Ventilation
American journal of critical care, Vol.32(5), pp.346-354
09/01/2023
DOI: 10.4037/ajcc2023403
PMID: 37652886
Abstract
Background
Pain assessment in the pediatric intensive care unit (PICU) is complex, specifically for children receiving mechanical ventilation who require neuromuscular blockade (NMB). No valid pain assessment method exists for this population. Guidelines are limited to using physiologic variables; it remains unknown how nurses are assessing and managing pain for this population in practice.
Objectives
To describe how PICU nurses are assessing and managing pain for children who require NMB.
Methods
A cross-sectional quantitative design was used with an electronic survey. Nurses were asked to respond to 4 written vignettes depicting a child who required NMB and had a painful procedure, physiologic cues, both, or neither.
Results
A total of 107 PICU nurses answered the survey. Nurses primarily used behavioral assessment scales (61.0%) to assess the child’s pain. All nurses reported that physiologic variables are either moderately or extremely important, and 27.3% of nurses used the phrase “assume pain present” formally at their organization. When physiologic cues were present, the odds of a nurse intervening with a pain intervention were 23.3 times (95% CI, 11.39-53.92; P < .001) higher than when such cues were absent.
Conclusions
These results demonstrate variation in how nurses assess pain for a child who requires NMB. The focus remains on behavioral assessment scales, which are not valid for this population. When intervening with a pain intervention, nurses relied on physiologic variables. Decision support tools to aid nurses in conducting an effective pain assessment and subsequent management need to be created.
Details
- Title: Subtitle
- Pain Assessment and Management for a Chemically Paralyzed Child Receiving Mechanical Ventilation
- Creators
- Elyse L Laures - University of IowaCynthia M LaFond - University of IowaBarbara St Marie - University of IowaAnn Marie McCarthy - University of Iowa
- Resource Type
- Journal article
- Publication Details
- American journal of critical care, Vol.32(5), pp.346-354
- DOI
- 10.4037/ajcc2023403
- PMID
- 37652886
- NLM abbreviation
- Am J Crit Care
- ISSN
- 1937-710X
- eISSN
- 1937-710X
- Language
- English
- Date published
- 09/01/2023
- Academic Unit
- Addiction Medicine; Nursing; Injury Prevention Research Center
- Record Identifier
- 9984461958202771
Metrics
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