Nursing assessment and management of pain in critically ill children.
OBJECTIVE
To describe how nurses assess and manage pain in critically ill children.


METHODS
Descriptive, comparative research design, with use of the Indicators of Pain in Critically Ill Children assessment tool.


METHODS
Twelve-bed pediatric intensive care unit in a metropolitan general hospital with a level II pediatric trauma center.


METHODS
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.


CONCLUSIONS
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.
Coffman
S
S
Broward General Medical Center, Ft. Lauderdale, FL 33316, USA.
Alvarez
Y
Y
Pyngolil
M
M
Petit
R
R
Hall
C
C
Smyth
M
M
D000293:Adolescent; D000701:Analgesics, Opioid / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009730:Nursing Assessment; D015588:Observer Variation; D010146:Pain / Q000145:classification / Q000451:nursing*; D010147:Pain Measurement / Q000451:nursing*
D000701:Analgesics, Opioid