Analgesics and sedatives (peds) - Revision history

Rossdonaldson1: /* Evaluation */

2022-11-16T18:52:48Z

Evaluation

← Older revision		Revision as of 18:52, 16 November 2022
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	==Evaluation==		==Evaluation==
	There are a number of well established frameworks for evaluating pain that are helpful in the pediatric ED~~. Which~~ framework works best is dependent on the age of the patient and provider preference<ref>“Pediatric Pain.” n.d. Accessed October 14, 2022. http://www.emra.org/books/pain-management/pediatric-pain/.</ref>.		*There are a number of well established frameworks for evaluating pain that are helpful in the pediatric ED; which framework works best is dependent on the age of the patient and provider preference<ref>“Pediatric Pain.” n.d. Accessed October 14, 2022. http://www.emra.org/books/pain-management/pediatric-pain/.</ref>.

	===Neonates===		===Neonates===
	CRIES Scale (used to establish baseline and assess discomfort over time):		CRIES Scale (used to establish baseline and assess discomfort over time):

Rossdonaldson1: /* See Also */

2022-11-16T18:51:57Z

Rossdonaldson1: /* Introduction */

2022-11-16T18:44:31Z

Introduction

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	==~~Introduction~~==		==Background==
	*Requires a more careful approach than typically needed in the adult population.		*Requires a more careful approach than typically needed in the adult population.
	*Children may require sedation for procedures that are done with topical anesthetic in the adult population and evaluation of pain in infants and young children can be challenging.		*Children may require sedation for procedures that are done with topical anesthetic in the adult population and evaluation of pain in infants and young children can be challenging.

Rossdonaldson1: /* Introduction */

2022-11-16T18:43:41Z

Introduction

← Older revision		Revision as of 18:43, 16 November 2022
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	==Introduction==		==Introduction==
	~~Analgesia and sedation considerations, particularly in the nonverbal population, requires~~ a more careful approach than typically needed in the adult population. Children may require sedation for procedures that are done with topical anesthetic in the adult population and evaluation of pain in infants and young children can be challenging~~. This page contains considerations for evaluation, options for anesthesia and sedation, and dosages for common analgesics and sedatives~~.		*Requires a more careful approach than typically needed in the adult population.
			*Children may require sedation for procedures that are done with topical anesthetic in the adult population and evaluation of pain in infants and young children can be challenging.

	==Evaluation==		==Evaluation==

Sschor at 11:31, 28 October 2022

2022-10-28T11:31:20Z

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 ===Intranasal and IV analgesia===
 If the above are not adequate or appropriate for the patient at hand, providers can consider inhaled analgesics or, if IV access is available, IV analgesia. As with adult patients, it is recommended to avoid opioids when possible. See below for common dose ranges for analgesics in the pediatric population.
 ==Disposition==

Sschor: /* Topical Anesthetics */

2022-10-20T00:42:07Z

Topical Anesthetics

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	===Topical Anesthetics===		===Topical Anesthetics===
	While not as frequently used in the adult context, topical anesthetics play a major role in pain management in pediatrics. The most frequent uses for topical anesthetics are enable PIV placement and to "pre-treat" open wounds prior to bedside evaluation and repair. Common options include~~<ref>“Pediatric Pain.” n.d. Accessed October 14, 2022. http://www.emra.org/books/pain-management/pediatric-pain/.</ref>~~:		While not as frequently used in the adult context, topical anesthetics play a major role in pain management in pediatrics. The most frequent uses for topical anesthetics are enable PIV placement and to "pre-treat" open wounds prior to bedside evaluation and repair. Common options include:
	{\| class="wikitable"		{\| class="wikitable"
	\|+ Topical Anesthetics		\|+ Topical Anesthetics

Sschor: /* Topical Anesthetics */

2022-10-20T00:40:23Z

Topical Anesthetics

← Older revision		Revision as of 00:40, 20 October 2022
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	While not as frequently used in the adult context, topical anesthetics play a major role in pain management in pediatrics. The most frequent uses for topical anesthetics are enable PIV placement and to "pre-treat" open wounds prior to bedside evaluation and repair. Common options include<ref>“Pediatric Pain.” n.d. Accessed October 14, 2022. http://www.emra.org/books/pain-management/pediatric-pain/.</ref>:		While not as frequently used in the adult context, topical anesthetics play a major role in pain management in pediatrics. The most frequent uses for topical anesthetics are enable PIV placement and to "pre-treat" open wounds prior to bedside evaluation and repair. Common options include<ref>“Pediatric Pain.” n.d. Accessed October 14, 2022. http://www.emra.org/books/pain-management/pediatric-pain/.</ref>:
	{\| class="wikitable"		{\| class="wikitable"
	\|+ ~~Caption text~~		\|+ Topical Anesthetics
	\|-		\|-
	! Name !! Principal Indication !! Onset/Duration		! Name !! Principal Indication !! Onset/Duration

Sschor at 00:39, 20 October 2022

2022-10-20T00:39:18Z

← Older revision		Revision as of 00:39, 20 October 2022
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	===Topical Anesthetics===		===Topical Anesthetics===
	While not as frequently used in the adult context, topical anesthetics play a major role in pain management in pediatrics. The most frequent uses for topical anesthetics are enable PIV placement and to "pre-treat" open wounds prior to bedside evaluation and repair. Common options include:		While not as frequently used in the adult context, topical anesthetics play a major role in pain management in pediatrics. The most frequent uses for topical anesthetics are enable PIV placement and to "pre-treat" open wounds prior to bedside evaluation and repair. Common options include<ref>“Pediatric Pain.” n.d. Accessed October 14, 2022. http://www.emra.org/books/pain-management/pediatric-pain/.</ref>:
			{\| class="wikitable"
			\|+ Caption text
			\|-
			! Name !! Principal Indication !! Onset/Duration
			\|-
			\| LET \|\| Use on open wound for laceration repair \|\| 30-45 minutes/variable
			\|-
			\| EMLA \|\| Use on intact skin. Can assist with PIV placement, LP, or abscesses \|\| 45-60 minutes/~120 minutes
			\|-
			\| LMX \|\| Use on intact skin. Can assist with PIV placement, LP, or abscesses \|\| 20-30 minutes/~60 minutes
			\|}

			===Intranasal and IV analgesia===
			If the above are not adequate or appropriate for the patient at hand, providers can consider inhaled analgesics or, if IV access is available, IV analgesia. As with adult patients, it is recommended to avoid opioids when possible. See below for common dose ranges for analgesics in the pediatric population.

	==Disposition==		==Disposition==

Sschor: /* Verbal Children >3yo */

2022-10-20T00:28:09Z

Verbal Children >3yo

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	===Verbal Children >3yo===		===Verbal Children >3yo===
			For pain assessment in the verbal child who is >3yo, consider using a visual pain scale such as the Wong-Baker scale (shown below).
	[[File:Wong-Baker.jpg\|thumb\|left]]		[[File:Wong-Baker.jpg\|thumb\|left]]
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	==Escalation of Care==		==Escalation of Care==
	Escalation of care generally depends on the source and severity of pain that the patient is experiencing. Consider starting with non-pharmacologic interventions and escalating to topical, oral, or IV as appropriate.		Escalation of care generally depends on the source and severity of pain that the patient is experiencing. Consider starting with non-pharmacologic interventions and escalating to topical, oral, or IV as appropriate.

Sschor at 21:02, 16 October 2022

2022-10-16T21:02:24Z

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	===Verbal Children >3yo===		===Verbal Children >3yo===
	[[File:Wong-Baker.jpg\|thumb\|left]]		[[File:Wong-Baker.jpg\|thumb\|left]]
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← Older revision		Revision as of 18:51, 16 November 2022
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	*[[Acute pain management\|Acute Pain Management]]		*[[Acute pain management\|Acute Pain Management]]
	*[[Pain_management_in_infants_and_children\|Pain Management in Infants & Children]]		*[[Pain_management_in_infants_and_children\|Pain Management in Infants & Children]]
			*[[Procedural sedation (peds)]]

	==References==		==References==