An Evidence-Based Approach to Minimizing Acute Procedural Pain in the Emergency Department and Beyond

Ali, Samina; McGrath, Tara; Drendel, Amy L.

doi:10.1097/pec.0000000000000669

Cited by 70 publications

(70 citation statements)

References 74 publications

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“…Nonpharmacologic methods that are commonly used to reduce the effects of invasive procedures in newborns include breastfeeding (Obeidat & Shuriquie, 2015;Pillai Ridell, et al, 2015;Harrison et al, 2016;Okan et al, 2010;Yilmaz & Arikan, 2011;Shah, Herbozo, Aliwalas, & Shah, 2012;Uga et al, 2008;Marín Gabriel et al, 2013;Aguilar Cordero, Mur Villar, García García, Rodríguez López, & Rizo Baeza, 2014), pacifiers (da Motta & da Cunha, 2015Yilmaz & Arikan, 2011), and sucrose and sweet solutions (Kassab, Anabrees, Harrison, Khriesat, & Chen, 2017;Kassab, Foster, Foureur, & Fowler, 2012;Pillai Riddell et al, 2015;Yilmaz & Arikan, 2011). Other alternatives include music therapy (Marofi, Nikobakht, Badiee, & Golchin, 2015); massage, touching, and positioning (Hartley, Miller, & Gephart, 2015); and nesting, kangaroo care, foetal positioning, and wrapping (Morrow et al, 2010;Prasopkittikun & Tilokskulchai, 2003;Okan et al, 2010;Obeidat & Shuriquie, 2015;Ali, McGrath, & Drendel, 2016;Cong, 2015;Shu et al, 2014). Breastfeeding is reported as effective in reducing pain during minor painful procedures (Chromá & Sikorová, 2012;da Motta & da Cunha, 2015;Obeidat & Shuriquie, 2015;Shah et al, 2012), and it is suggested that it should be used to reduce pain during interventional procedures in newborns (Ali et al, 2016;Reece-Stremtan & Gray, 2016;Shah et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

“…Other alternatives include music therapy (Marofi, Nikobakht, Badiee, & Golchin, 2015); massage, touching, and positioning (Hartley, Miller, & Gephart, 2015); and nesting, kangaroo care, foetal positioning, and wrapping (Morrow et al, 2010;Prasopkittikun & Tilokskulchai, 2003;Okan et al, 2010;Obeidat & Shuriquie, 2015;Ali, McGrath, & Drendel, 2016;Cong, 2015;Shu et al, 2014). Breastfeeding is reported as effective in reducing pain during minor painful procedures (Chromá & Sikorová, 2012;da Motta & da Cunha, 2015;Obeidat & Shuriquie, 2015;Shah et al, 2012), and it is suggested that it should be used to reduce pain during interventional procedures in newborns (Ali et al, 2016;Reece-Stremtan & Gray, 2016;Shah et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

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Effects of breastfeeding and heel warming on pain levels during heel stick in neonates

Aydın

İnal

2019

Int J of Nursing Practice

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Aim To determine the effects of two different methods, breastfeeding and heel warming, during heel stick procedures on pain levels in healthy term neonates. Methods This study was a prospective, randomized controlled trial. The sample of the study consisted of 150 healthy newborns who matched the case selection criteria and were brought to the nursery for the heel stick procedure. Fifty neonates were randomly assigned to each group: breastfeeding (n = 50), heel warming (n = 50), and control (n = 50), using computer‐based randomization. The study data were obtained using an Information Form and the Neonatal Infant Pain Scale (NIPS). Results The pre‐procedural pain scores of the breastfeeding group (mean 4.44 SD 1.21 seconds) were lower than in the heel warming (mean 6.10 SD 1.07 seconds) and the control group (mean 6.42 SD 0.91 seconds) (P < 0.01). Both the total crying time and the first calming time of the breastfeeding group were shorter than the heel warming and control group. The first calming time of the heel warming group was shorter than in the control group. Conclusions Both breastfeeding and heel warming are effective in reducing the calming time during heel stick procedures. However, breastfeeding is more effective than heel warming in reducing pain during heel stick and should be preferred as the first choice.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of breastfeeding and heel warming on pain levels during heel stick in neonates

Aydın

İnal

2019

Int J of Nursing Practice

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“…When used appropriately; non-pharmacologic methods can be effective in dulling procedural pain. Non-pharmacologic methods used in children can be categorized in three main groups: supportive methods, cognitive/behavioral methods and physical methods [11][12][13][14]. Supportive methods comprise techniques, such as watching a video, reading a book, family's presence alongside the child during painful procedure; physical methods include touching, giving position, massage, skin stimulation, hot and cold pack application [11,15].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Effectiveness of Buzzy, Distracting Cards and Balloon Inflating on Mitigating Pain and Anxiety During Venipuncture in a Pediatric Emergency Department

Tork¹

2017

AJNS

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Abstract:Background Painful medical procedures in childhood may have long-term negative effects on development and future tolerance of pain, evidence suggests that a significant number of children receive less than optimal management of procedure-related pain Objective The present study aim to investigate the efficacy of three interventions methods (Buzzy, distracting cards and balloon inflating) on mitigating pain and anxiety associated with venipuncture in a group of pediatric patients. Methods A prospective randomized clinical trial with children who required venipuncture and aged 7 to12 years was conducted in a pediatric ED. Data were obtained by conducting interviews with the children, their parents, and the observer. The pain levels of the children were assessed by the parent, observer as well as self-report using the Faces Pain Scale-Revised (FPS-R). The anxiety levels of children were assessed using Children Fear Scale (CFS). Results One hundred and eighty children (mean age, 9.3±1.9 years) were included. The pain levels of children showed statistically significant differences between the groups in the self-, observer-and parent-reported procedural pain (p = 0.012, p = 0.036, p = 0.014 respectively).No significant differences were observed between the groups in procedural child anxiety levels according to the parents and observer (p =0. 42, 0.13 respectively). Conclusion The results of the study suggests that the distraction method through Buzzy, distraction cards and balloon inflating are effectively decreased pain levels of children compared with the control group according to self-report, parent-report and observer-report.

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“…Because topical liposomal lidocaine and amethocaine have a faster onset of action, they seem to be more attractive agents than EMLA Ò for use in the ED, where time restraint is often an issue [98].…”

Section: Topical Anestheticsmentioning

confidence: 99%

“…Dose ranges vary in the different protocols published, from as low as 0.05-0.5 ml in newborns to 2 ml given 2 min prior to the procedure and completion of the dose during the procedure if starting with a lower dose, up to a total of 1-2 ml of sucrose 24-33 % per procedure in term infants [97][98][99].…”

Section: Sucrosementioning

confidence: 99%

Managing Pediatric Pain in the Emergency Department

Bailey

Trottier

2016

Pediatr Drugs

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Far more attention is now given to pain management in children in the emergency department (ED). When a child arrives, pain must be recognized and evaluated using a pain scale that is appropriate to the child's development and regularly assessed to determine whether the pain intervention was effective. At triage, both analgesics and non-pharmacological strategies, such as distraction, immobilization, and dressing should be started. For mild pain, oral ibuprofen can be administered if the child has not received it at home, whereas ibuprofen and paracetamol are suitable for moderate pain. For patients who still require pain relief, oral opioids could be considered; however, many EDs have now replaced this with intranasal fentanyl, which allows faster onset of pain relief and can be administered on arrival pending either intravenous access or definitive care. Intravenous opioids are often required for severe pain, and paracetamol or ibuprofen can still be considered for their likely opioid-sparing effects. Specific treatment should be used for patients with migraine. In children requiring intravenous access or venipuncture, non-pharmacological and pharmacological strategies to decrease pain and anxiety associated with needle punctures are mandatory. These strategies can also be used for laceration repairs and other painful procedures. Despite the gaps in knowledge, pain should be treated with the most up-to-date evidence in children seen in EDs.

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An Evidence-Based Approach to Minimizing Acute Procedural Pain in the Emergency Department and Beyond

Cited by 70 publications

References 74 publications

Effects of breastfeeding and heel warming on pain levels during heel stick in neonates

Effects of breastfeeding and heel warming on pain levels during heel stick in neonates

Comparison of the Effectiveness of Buzzy, Distracting Cards and Balloon Inflating on Mitigating Pain and Anxiety During Venipuncture in a Pediatric Emergency Department

Managing Pediatric Pain in the Emergency Department

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