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Evaluating comfort measures for commonly performed painful procedures in pediatric patients

Sana Dastgheyb1, Keith Fishlock2, Constantine Daskalakis1

  • 1Thomas Jefferson University, Philadelphia, PA, ssd005@jefferson.edu.

Journal of Pain Research
|August 14, 2018
PubMed

Insights

Distraction (DIST) is most effective for younger children undergoing painful medical procedures, while positions of comfort (POC) benefit older children. This research guides pediatric pain management strategies.

Area of Science:

  • Pediatric Medicine
  • Pain Management
  • Medical Procedures

Background:

  • Effective management of pediatric procedural pain is crucial for patient care and experience.
  • Acute pain in infants and children requires optimized comfort measures.
  • Previous research highlights the need for evidence-based strategies in pediatric pain control.

Purpose of the Study:

  • To investigate the efficacy of different comfort measures in managing acute procedural pain in children.
  • To determine the correlation between comfort measures and the number of attempts needed for procedures.
  • To compare positions of comfort (POC), distraction (DIST), and pharmacological (PHARM) methods.

Main Methods:

  • Retrospective review of 74,276 procedures across two pediatric hospitals (2013-2016).
  • Comparison of POC, DIST, and PHARM in four procedures: peripheral intravenous (PIV) catheter insertion, gastrointestinal tube placement, incision, and bladder catheterization.
  • Efficacy measured by the number of attempts required to complete a procedure.

Main Results:

  • Distraction (DIST) was significantly more effective for infants (<1 year) and toddlers (1-3 years) in procedures like PIV catheterization.
  • Positions of comfort (POC) showed superiority for older children, particularly in PIV catheterization for adolescents (13-21 years) and urinary catheterization (9-12 years).
  • The number of attempts needed was used as a proxy for minimizing distress during painful procedures.

Conclusions:

  • Findings can inform the selection of appropriate comfort measures for pediatric procedural pain.
  • Distraction appears optimal for younger pediatric populations, while positions of comfort may be more suitable for older children.
  • This study provides data-driven insights for improving pediatric pain management protocols.
Abstract

Keywords:
acute paincomfort measurespain managementpediatric paintherapeutic

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