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[Management of puncture pain in hospitalized children]
Leonor C Martínez1, Marcela Ortiz2, Marcela Monge1
1Departamento de Pediatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Insights
Implementing pain management strategies for pediatric punctures significantly reduces patient discomfort and improves the overall hospitalization experience. Protocolized care leads to lower pain scores and high parental satisfaction.
Area of Science:
- Pediatric pain management
- Minimally invasive procedures
- Healthcare quality improvement
Context:
- Punctures are a primary source of pain for hospitalized children.
- Effective pain management is crucial for improving pediatric patient experiences.
- A pediatric intermediate care unit sought to enhance procedural care.
Purpose:
- To introduce and evaluate strategies for relieving puncture-associated pain in a pediatric intermediate care setting.
- To assess the effectiveness of interventions like topical lidocaine.
- To gather parent/caregiver feedback on implemented pain relief measures.
Summary:
- A retrospective study analyzed 89 procedures in 72 children, with peripheral venous catheter insertion being most common.
- Topical 4% lidocaine was the most frequent intervention (76%).
- Pain scores were low (CHEOPS scale) and positive behaviors were observed (FRANKL scale), with 79% of parents reporting reduced pain.
Impact:
- Protocolized pain management strategies are effective in reducing pediatric procedural pain.
- High parental acceptance (98% would request again) indicates successful implementation.
- Standardized protocols offer a low-cost, easily applicable method for improving pediatric patient and caregiver experiences.
Abstract:
Punctures are the main cause of pain during hospitalization in pediatrics. The application of a protocolized management improves the hospitalization experience.
Objective:
To describe the in troduction of different strategies aimed at relieving pain associated with punctures in a pediatric middle care unit.
Patients And Method:
Descriptive retrospective study carried out between Octo ber 2018 and May 2020 in a pediatric intermediate care unit of the HCUC (Santiago, Chile). Data analysis included demographic information, type of painful procedure, therapeutic intervention, duration of the procedure, pain scales (CHEOPS and Frankl), and parent/caregiver opinion survey.
Results:
89 procedures, in 72 children, mean age 4.5 years. The most frequent painful procedure was Peripheral venous catheter insertion in 41.6% (n = 37) of children, with a mean duration of 7.5 min. The most used therapeutic intervention was the application of topical 4% lidocaine in 76% (n = 68); 73% of the patients presented an evident positive behavior according to the FRANKL scale and, according to CHEOPS, 77.5% presented mild pain. The parent/caregiver survey showed that 79% reported less pain compared with previous puncture episodes, and 98% would request the same measures next time.
Conclusions:
The application of different strategies to manage pain caused by punctures is associated with low pain scores and favorable parental acceptance. The use of standardized management protocols could allow better approaches and experiences for patients and their parents/caregivers at low cost and easy applicability.
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