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Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
Published on: July 4, 2018
Complex pain consultations in the pediatric intensive care unit
1Department of Anesthesiology and Perioperative Medicine, Doernbecher Children's Hospital, Oregon Health and Science University, Portland, Oregon 97239-3098, USA. turnerh@ohsu.edu
Insights
Managing pain in critically ill children is challenging. Multidisciplinary pediatric pain services can improve pain assessment and treatment for these vulnerable patients.
Area of Science:
- Pediatric intensive care
- Pain management
- Critical care medicine
Background:
- Pain assessment and management in children present unique difficulties, especially within the critical care setting.
- The critical condition and complex illnesses of pediatric patients complicate pain management.
- The emotional intensity of the critical care environment further challenges pain control.
Observation:
- Pediatric intensive care units (PICUs) encounter diverse pain syndromes.
- Healthcare staff in PICUs may lack familiarity or comfort in managing these complex pain cases.
- Effective pain management requires specialized knowledge and skills.
Findings:
- Pain assessment and treatment in critically ill children are often suboptimal.
- The multidimensional nature of pediatric critical illness impacts pain perception and management.
- Lack of specialized expertise contributes to difficulties in pain control.
Implications:
- Multidisciplinary pediatric pain services are crucial for optimizing pain care in PICUs.
- Expert guidance from pain services can enhance the assessment and treatment of pediatric pain.
- Improved pain management in critical care settings can lead to better patient outcomes.
Abstract:
The assessment and management of pain in children is not always easy and it is clearly more difficult in the critical care setting. Pain management is further complicated in this vulnerable population by the nature of their critical condition, the complexity and multidimensionality of their illness or injuries, and the intensity of emotions in this environment. A variety of pain syndromes are encountered in the pediatric intensive care unit, and the staff there may not be familiar with or comfortable managing these cases. Pain assessment and treatment can be more appropriately managed when guided by the experts of a multidisciplinary pediatric pain service.
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