procedure is being painful procedures. performed) can also be The sucrose causes the an effective method to release of endogenous reduce pain. This endorphins and thus method demonstrates reduces the pain. use of the Gate Theory, Infants provided similar to the method sucrose were found to used by dentists who cry less and returned to jiggle the lip before their baseline condition giving intraoral quicker after injections. procedures. Pacifiers There are a number alone can also be of non-invasive agents effective for analgesia. that can be used to There are a number reduce pain in the of other pain-reducing emergency setting. strategies that are Some can be applied beyond the scope of immediately prior to this article. The methods procedures, and others discussed can take a must be applied 20 to minimal amount of time 30 minutes in advance and can significantly of a procedure to reduce pain effectively engage maximum in the pediatric patient. Figure 2: Skin blanched after 20 minutes of LET application. benefit. Topical vapocoolant spray is References an anesthetic skin refrigerant that instantly reduces pain for needlesticks and other skin punctures. It can be applied to 1. MacLean, S., Obispo, J., & Young, K.D. (2007.) The gap minor open wounds or intact skin (such as abscesses). It is between pediatric emergency department procedural pain sprayed for 4 to 10 seconds or until the skin is blanched, management treatments available and actual practice. with a resultant 60 seconds of transient anesthesia to Pediatric Emergency Care, 23(2): 87-93. perform the procedure. Liposomal lidocaine 2. Taddio, A., Katz, J., Ilersich, A. L., & Koren, G. (1997.) (4 percent) cream can be applied to intact skin to reduce Effect of neonatal circumcision on pain response during pain from venipunctures. It can be placed over two areas subsequent routing vaccination. The Lancet, 349(9052), where the vein is most prominent, often the antecubital area 599-603. and dorsum of the hand, for approximately 20 to 30 minutes 3. Broome, M. (2000.) Helping parents support their child in before IV starts. Two areas are typically used in case the first pain. Pediatric Nursing, 26(3), 315-317. IV attempt is unsuccessful. For open wounds, mixtures of lidocaine, epinephrine and tetracaine can be applied to lacerations in the triage area. LET is applied to a cotton ball or other nonabsorbent dressing and taped in place. As an alternative to using tape over the dressing, the parent can wear a glove and apply pressure to the dressing over the wound for approximately 20 to 30 minutes before laceration cleansing and repair. The skin will become blanched from the epinephrine in the LET (see Figure 2). Other considerations include application of viscous Head to enajoann.wordpress.com or lidocaine jelly to the urethra for approximately 10 minutes the ENA website, www.ena.org, to read the before urethral catheterization attempts in infants. Infants latest posts from 2013 ENA President JoAnn Lazarus, can be provided sucrose solution by dipping a pacifier in the MSN, RN, CEN, in her new ENA President’s Blog. sucrose and giving it to the infant before, during and after
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