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EMERGENCY SEDATION AND PAIN MANAGEMENT - PART 2

Tổng quan và nguyên tắc giảm đau An thần khẩn cấp và thiết bị độ tuổi cụ thể thủ tục, và các tiêu chuẩn xả nên được thường xuyên trong tất cả các thuốc giảm đau gặp bệnh nhân trẻ em và an thần. Tài liệu tham khảo 1. Krauss B, Green SM. Thủ tục an thần và giảm đau ở trẻ em | 16 Overview and Principles in Emergency Analgesia and Procedural Sedation age-appropriate level. If the patient is nonverbal use of an infant score such as the FLACC Scale may be necessary. In addition the parents may be able to assist in describing some of the child s pain behaviors or facial expressions. Monitoring requirements for these children may require the addition of cardiac rhythm assessment for children with cardiovascular problems. After the procedure these children may require monitoring for a longer period than typically utilized to guard against an enhanced risk for respiratory depression. Discharge criteria should still be met although reaching some of the child s baseline behaviors may depend on the parents assessment. FOLLOW-UP DISCHARGE CONSIDERATIONS Specific discharge criteria for children following sedation events should include the following 1. Cardiovascular function and airway patency are satisfactory and at baseline. 2. The patient is easily arousable and protective reflexes are intact. 3. The patient can talk if age appropriate . 4. The patient can sit up unaided if age appropriate . 5. The patient has returned to the presedation level of responsiveness. 6. The child s hydration status is adequate. A reliable adult should be given discharge instructions for the pediatric patient at the time of discharge from the ED. These should note that the child may be drowsy for a few hours the adult should not leave the child unattended in a car seat and the child should be prohibited from unattended swimming or bathing for 8 hr. Postdischarge feeding should include precautions concerning the avoidance of a heavy meal for a few hours as some children will have mild nausea after PSA. SUMMARY Over the years emergency physicians are increasingly asked to provide sedation and analgesia to pediatric patients for numerous diagnostic and therapeutic procedures. Adherence to existing guidelines for patient assessment medical personnel patient monitoring .