Nursing assessment and management of pain in critically ill children
1997; Elsevier BV; Volume: 26; Issue: 3 Linguagem: Inglês
10.1016/s0147-9563(97)90059-5
ISSN1527-3288
AutoresSherrilyn Coffman, Yvette Alvarez, Mariamma Pyngolil, Robin Petit, Corrine Hall, M Smyth,
Tópico(s)Family and Patient Care in Intensive Care Units
ResumoAbstract OBJECTIVES: To describe how nurses assess and manage pain in critically ill children. DESIGN: Descriptive, comparative research design, with use of the Indicators of Pain in Critically Ill Children assessment tool. SETTING: Twelve-bed pediatric intensive care unit in a metropolitan general hospital with a level II pediatric trauma center. PARTICIPANTS: Twenty-four pediatric intensive care unit nurses who conducted 112 assessments of 25 critically ill children. RESULTS: Pain indicators selected most frequently by nurses included cardiovascular and respiratory changes (increased heart rate, respiratory rate, and blood pressure), followed by behavioral indicators (irritable/fussy, verbalizing pain, crying), and neuromuscular responses (tenseness/rigidity, squirming, drawing up legs). The average number of pain indicators selected during each medication event was 5.3. More indicators were selected for trauma, surgery, and younger patients; fewer indicators were selected for patients receiving ventilation treatment. CONCLUSION: Pain assessment of critically ill children includes unique indicators, as compared to less sick children, and must take into account the child's decreased ability to communicate pain.
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