Pediatric Pain Management Term Paper

Optimal postoperative pain control is of utmost importance in the surgical population. 1-2 Analgesic techniques in paediatric patients having surgery are often delayed by the inherent difficulties of conducting a large randomized clinical trial in those patients. 3,-4 The optimal dose of local anaesthetics in paediatric regional anaesthetic techniques remain unknown. 5- 6

Children have multiple or prolonged exposure to trauma, experience various symptoms and reactions, and long for progressive techniques to heal their pain.

JCAHO (2011) also stated that patients and their families needed to be educated about pain and how the patients’ pain is going to be managed. Every patient perceives and exhibits pain in a different manner and if nurses do not assess the patient thoroughly they can miss it. For instance, Engebretson et al. (2006) acknowledged that, patients manifest pain in different ways and this resulted in nurses performing an inadequate assessment of their patients’ pain. Also, Engebretson et al. recognized that patients often conceal their pain because they do not want to be viewed by staff as complainers or addicts, and if patients decide to speak up the nurses frequently view their patients’ statements from their own cultural, moral and ethical belief system and not their patients which leaves the patients’ pain untreated.

The concept of “pediatric anxiety” emerged as a central theme in a study of pediatric patients in the Pediatric Emergency Department in order to better care for the pediatric population, determine the source of the patient’s fears, along with providing all encompassing care to pediatric patients. Therefore, I decided to examine the concept of pediatric anxiety. Pediatric patients often attribute hospitals, nurses, and doctors with needles as most often the healthy child sees their pediatrician for well child check ups and immunizations. Some pediatric patients have been diagnosed with anxiety and deal with anxiety on a daily basis while others ' anxiety arises with emergency department visits and hospitalizations. Pediatric anxiety in the hospital can be a result of a multitude of factors and can be demonstrated in a multitude of ways. While some patients may scream and cry, others may become withdrawn. Walking into the doors of an unknown place while feeling sick or experiencing pain, can certainly produce anxiety for patients of all ages. Particularly pediatric patients, with their fear of strangers, inability to comprehend the rationale behind illness or providing care for such illnesses and diseases, and fear of "getting hurt or needles" can all be contributors to anxiety. “Hospitalization can be a threatening and stressful experience for children. Because of unfamiliar with the environment and medical procedures and unaware

This paper is a research critique of the article titled, “ Effect of distraction on children’s pain during intravenous catheter .” Sadeghi, Mohammadi, Shamshiri, Bagherzadeh & Hossinkhani (2013) conducted the study using a soft ball for the children to press during intravenous catheter insertion. This paper will critique the design, sample and setting, ethical considerations, data collection and analysis, and the results with recommendations of the researchers.

Specific Purpose: To inform my audience about the different forms of pain management used during childbirth.

It has been documented that children undergoing surgery and their families experience high levels of distress and perioperative anxiety. Stress and perioperative anxiety have the potential to cause more harm on post-surgical healing, in consideration of both physical and mental health, if not addressed promptly and properly. Child Life Specialists are pediatric healthcare professionals who are able to provide interventions to help reduce anxiety and increase developmental growth within pediatric patients, provide family centered care, and facilitating therapeutic play interventions for pediatric patients, all the while in the hospital environment (Child Life Council, 2014). Child life specialists are able to meet these values and missions to create a standard of practice that the American Pediatric Association recommends in all pediatric healthcare settings (Child Life Council, 2014). Typically, when child life specialists are working with pediatric patients undergoing anesthesia for surgical procedures they are able to participate as a part of the multidisciplinary health team to provide family centered care and increase a patient and their families understanding on the medical procedure at hand. A common intervention for pediatric patients undergoing anesthesia for surgical procedures include medical play and medical preparation sessions.

The database was searched for main terms for information on the related topic included oral sucrose, infants, and immunizations. Alternative terms included oral sweeteners, neonates, needles, and analgesia. MeSH terms included Needles*, Sucrose/*administration & dosage, Pain/*prevention & control, Punctures/*adverse effects, Sweetening Agents/*administration & dosage, Humans; Infant; Randomized Controlled Trials as Topic. Inclusion criteria included infants < 1 year of age, publication dates: 2005-2016, randomized control trial, systematic review, USA, glucose/sucrose,

Children are taken to the emergency department for various reasons, but pain is one of the most common. Habich and Letizia state, “Despite the high frequency of pain, pediatric patients are often not appropriately assessed for pain.” Nurses and other medical personnel failing to properly assess the pain in the emergency department is a problem that needs to be fixed. To resolve this problem, Habich and Letizia decided to conduct an evidence based protocol to review what ways the program needed to review.

Children often fear medical procedures especially ones that are invasive and elicit large amounts of pain and discomfort. For this reason, it is important to prepare children prior to them starting an invasive medical procedure. The objective of

There are several strengths to this study. This is the largest randomized, controlled, clinical trial comparing neonatal pain between Gomco and Mogen clamps. Furthermore, by having all the circumcisions be performed by a single provider group, the authors were able to control for provider confounders. Both procedure protocols were solely based on the most recent recommendations from the American Academy of Pediatrics. However, as the study was exclusive to healthy and term infants, the results can only be generalized to this population, not to premature infants or older males. Another limitation is that these observations are regarding short-term outcomes of the procedures, not long-term outcomes of Gomco and Mogen clamp circumcisions. Furthermore, the research nurses who scored the pain were not blinded to the treatment

Marion Good, PhD, RN, has focused her study, “A Middle-Range Theory of Acute pain Management: Use in Research,” on complementary medicine for pain and stress, acute pain, and stress immunity. The purpose of this theory is to put into practice guidelines for pain management. Good, 1998, noted the need for a balance between medication usage and side effects of pain medications. The theory also promoted patient education related to pain management following surgery and encouraged plan development for acceptable levels of pain management. This theory was developed through deductive reasoning. Chinn & Kramer, 2008, defined deductive reasoning as going from a general concept to a more specific concept.

Pediatric pain management is measured subjectively because it is based off of what the patient says or how the nurse interprets the pain scale. Pain is rated using different scales, unfortunately these different scales could yield different results. Nurses are trained to use pediatric pain scales to analyze and treat pain but parents are not supplied with the tools to manage pain when the patient goes home. With 84% of all pediatric surgical procedures performed on an outpatient basis, the importance of teaching parents how to assess for and manage pain has become more important than ever (Rony, Fortier, Chorney, Perret, & Kain, 2010). According to Rony’s et al. (2010) study, it is apparent that pediatric pain is not being treated effectively. The study showed that 58.8% of children were receiving less than the daily recommended does prescribed by the pediatrician (p.1). Results of the study also showed that parents had false assessments on if their child was actually in pain. 36% of parents believed that if their child was in pain, they would cry out for the parent , 30% agreed that their child would always tell them if they are in pain, while 22% said that the child would report their pain immediately (Rony, Fortier, Chorney, Perret, & Kain, 2010, ). Children do not always verbalize when they are in pain. Sometimes the pain can be so intense that a child is unable to talk. If the child catches on to the parents negative perception of pain medications, the child may not

Numerous other forms of non-pharmacological treatment exist, but require more research in order to gain acceptance in the medical community. These treatments include, but are not limited to, herbal medicine and acceptance based therapy. Researchers Rao Liu and Ning Wang studied the use of Chinese herbal medicine, and found limited results due to the lack of clinical studies and basic research regarding Chinese herbal medicine (7). Lastly, a study was conducted to test the effectiveness of acceptance based therapy in young children with functional abdominal pain. Instead of using distraction as a pain management technique, children were encouraged to express their pain, in hopes of children being able to better differentiate pain from other sensations (Zucker, Nancy, et al 201). However, there is a need for more rigorous trials to further develop this research. Functional abdominal pain has vast treatment variety, but lacks the trials and evidence to

The study sought to improve patient care in three areas. The first area was improving pain assessment documentation by introducing a standardized pediatric assessment. The second area was decreasing the time the patient received pain medication. The last area was evaluating the effect of the nursing intervention in reducing the pediatric patient’s pain at discharge via a pain scale. This study was conducted at a 35 bed level 2 emergency department in the United States. A total of 1200 EMRs were collected from pediatric patients ranging from 3 months to 6 years in age (Ramira et al., 2016, p. 43). Half of the cases were review before the