© 1999 Designer Illustrations Supported by
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Title:
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Guidelines on the Management of Pain in Children | |||||||||
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Purpose:
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The guidelines were devised and written over the last 5 years to accompany setting up an Acute Pain Service and are a working document of that service. | |||||||||
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Approval/ revision date:
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Oct-98 | |||||||||
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document type:
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guidelines | |||||||||
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Intended audience:
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healthcare professionals | |||||||||
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Institution type:
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children's hospital, general hospitals | |||||||||
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Drug type:
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general anesthetic, topical anaesthetic, NSAIDS, opioids | |||||||||
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Pain type:
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disease, procedural, surgical/trauma | |||||||||
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Delivery technique:
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intravenous, PCA, topical, epidural, oral, inhaled | |||||||||
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Nonpharmacological treatments:
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Age:
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neonate, child, adolescent | |||||||||
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Disease type:
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sickle-cell | |||||||||
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Name:
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Mary Cunliffe | |||||||||
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Title:
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Consultant Paediatric Anaesthetist | |||||||||
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Institution:
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Royal Liverpool Children's NHS Trust | |||||||||
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Department:
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Alder Hey Pain Service | |||||||||
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Address:
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Eaton Road Liverpool UK L12 2AP |
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Telephone:
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0151-252-5223 | |||||||||
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Fax:
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0151-252-5460 | |||||||||
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Email:
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<M.Cunliffe@liverpool.ac.uk> | |||||||||
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Type of institution:
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specialist children’s hospital with tertiary care facilities | |||||||||
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Number of beds:
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265 beds | |||||||||
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Supervising specialist availability:
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paediatric anesthesiologist on call 24 hours per day | |||||||||
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| All these guidelines have been written and rewritten over the last 5 years to guide practice in a large paediatric hospital. The Acute Pain Srevice manages 1500 to 2000 children per year having major surgery. The majority of these guidelines used daily throughout the hospital with few problems. The newest guideline in the book is that for caudal infusions in babies. We are in the process of devising an NCA protocol for our neonates having surgery. Our burns dressing guideline using IV morphine and midazolam has been used for the last 6 months. It replaces an oral morphine and midazolam policy which did not work well in all children. The new IV policy is effective and seems to have few problems. These guidelines are currently published in book form and sold by the hospital. We have done a reprint of the book and aim to revise it at the end of the year, adding in guidelines on ketamine infusions, NCA for neonates, withdrawal from long-term opioid administration, use of EMLA in neonates and sucrose for procedural pain. | ||||||||||
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| see references at end of document | ||||||||||
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| Overall, very thorough. Consideration to add suggestions for monitoring in the section on sedation for patients in the burn unit. If the authors feel this is adequately covered in other policies for their institution, this may suffice. However, if it is to be distributed outside the institution, reinforcement of monitoring guidelines may be useful. | ||||||||||
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Reviewer:
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Jeffrey Koh, MD Director - Pediatric Pain Management Arkansas Children’s Hospital |
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Review date:
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Apr-00 | |||||||||
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