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Pediatric Emergency MedicinePediatric Emergency Medicine

Section II. Sedation, Analgesia, and Imaging > 

Chapter 21. Pain Management

Amy L. Baxter, Lindsey L. Cohen
Topics Discussed: neurology; pain management.
Sections: Pain Management: Introduction, Oligoanalgesiaforpediatric Emergency Patients, Pain Assessment, Procedural Pain Management, Sickle Cell Pain, Analgesic Agents, Behavioral Pediatric Pain Management, References.
Excerpt:"
  • Untreated, pain in children causes short and long-term consequences, and its monitoring in the emergency department should be considered a "fifth vital sign."
  • The numbing effect of topical lidocaine and tetracaine preparations can be considered effective when there is visible blanching of surrounding tissue.
  • Buffering intradermal lidocaine with 1:9 concentration of sodium bicarbonate will reduce pain from chemical irritation.
  • When removing packing from an abscess, moisten the edges of the packing with lidocaine, epinephrine, and tetracaine to allow for more painless removal.
  • Oral sucrose on a pacifier can provide pain relief for small infants during painful procedures.
  • Children report the most painful part of fracture management is obtaining radiographs. This can be reduced by early splinting of the fracture site.
  • Behavioral techniques for management of pain include relaxation exercises, deep breathing, distraction, and imagery.
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