2015 Trumbull Memorial Hospital Demo

Pediatric Pain Control Pediatric Pain Control

Universal Pediatric Assessment

Clinical Considerations Make parents aware:  Ketamine is a hallucinogen  Ketamine causes nystagmus Second dose must be clearly justified

Clinical Considerations  Ketamine IV/IO must be diluted to 5mg/mL  Do not dilute ketamine for MAD or IM routes  Ketamine may be less effective via MAD or IM  Alternative routes are offered to minimize patient anxiety and facilitate administration  Biovailability of alternative routes guides the dose ranges

Keep patient calm

Use Wong-Baker Faces pain scale

Determine cause of pain

Clinical Considerations Ketamine Contraindications:  Patients < 2 months old  Schizophrenia  Allergy to ketamine

Pediatric IV/IO

< 16 years old

Painful Procedures Cardioversion TCP

Visceral Pain Non-obvious Sources

Orthopedic Pain Obvious Sources of Pain

Consider Ketamine 0.4mg/kg IV/IO/IM Maximum 40mg . Be prepared for side effects  Hallucinations  Nausea  Nystagmus

If not given in the last 6 hours: If older than 6 months: If clearly justified: Tylenol 15mg/kg PO Maximum 500mg

Ketamine 0.2mg/kg IV/IO/IM or Ketamine 0.3 mg/kg Nebulized or Ketamine 1 mg/kg via MAD Repeat IV/IO dose in 10 minutes if source of obvious pain

Zofran 1 month to 12 years old <30kg/66lbs: 0.1mg/kg IV/IO x 1 or ½ an ODT >30kg/66lbs: 4mg IV/IO/ODT Maximum 4mg

Clinical Considerations Never delay a lifesaving therapy such as cardioversion or TCP to provide sedation.

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EMR

EMT

AEMT

Paramedic

Extended