How often do we perform painful and stressful procedures in the paediatric intensive care unit? A prospective observational study
| Autor: | Sharan Jhingoer, Manuel A. Baarslag, Dick Tibboel, Erwin Ista, Karel Allegaert, Monique van Dijk |
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| Přispěvatelé: | Pediatric Surgery, Child and Adolescent Psychiatry / Psychology |
| Rok vydání: | 2019 |
| Předmět: |
Male
Paediatric intensive care medicine.medical_specialty Adolescent Critical Care medicine.drug_class Sedation Pain Polysomnography Emergency Nursing Intensive Care Units Pediatric Stress Critical Care Nursing 03 medical and health sciences 0302 clinical medicine Interquartile range medicine Humans Pain Management Prospective Studies 030212 general & internal medicine Child Children Pain Measurement Venipuncture medicine.diagnostic_test Diagnostic Tests Routine business.industry Lumbar puncture Infant Newborn Infant 030208 emergency & critical care medicine Respiration Artificial Child Preschool Sedative Emergency medicine Female Observational study Analgesia medicine.symptom business Cohort study |
| Zdroj: | Australian Critical Care, 32(1), 4-10. Elsevier Ireland Ltd |
| ISSN: | 1036-7314 |
| Popis: | BACKGROUND: Adequate analgesia and sedation is crucial in critical care. There is little knowledge on the extent of painful and stressful procedures on children admitted to a paediatric intensive care unit (PICU) and its analgesic and/or sedative management. OBJECTIVE: The primary objective was to determine the number of painful and stressful procedures per patient per day in our PICU patients, including the numbers of attempts. A secondary objective was to map PICU nurses' perceptions of the painfulness of the included procedures. METHODS: A prospective, single-centre observational cohort study in a tertiary PICU. All patients admitted to the PICU over a 3-month period were eligible. Readmissions, polysomnography patients, and patients without any data have been excluded. The number of painful and stressful procedures was collected daily, and use of analgesics and sedatives was assessed and recorded daily. Twenty-five randomly assigned nurses rated the painfulness of procedures based on their personal experience using a numeric rating scale from 0 to 10. RESULTS: In a 3-month period, a total of 229 patients were included, accounting for 855 patient days. The median number of painful and stressful procedures per patient per day was 11 (interquartile range=5-23). Endotracheal suctioning was the most frequent procedure (45%), followed by oral and nasal suctioning. Arterial and lumbar puncture, peripheral IV cannula insertion, and venipuncture were scored as most painful ranging from 3 to 10. Procedural analgesia or sedation was often not used during these most painful procedures. CONCLUSIONS: Mechanically ventilated patients undergo more than twice as many painful procedures than non-ventilated patients, as endotracheal suctioning accounts for almost half of all. Nurses regarded skin-breaking procedures most painful; however, these were rarely treated by procedural analgosedation and only covered in the minority of cases by adequate background analgosedation. ispartof: AUSTRALIAN CRITICAL CARE vol:32 issue:1 pages:4-10 ispartof: location:Australia status: published |
| Databáze: | OpenAIRE |
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