In the pediatric Intensive Care Unit (PICU) there is a need for analgesia and sedation to reduce pain and discomfort, allow for interventions, optimize ventilation, decrease the amount of time in the PICU, and improve outcomes including the time after discharge. Adequate management of sedation and pain is the key to healing, duration of hospitalization, as well as a decrease in mortality rates. It is essential to have adequate pain control to maintain healing and stress reduction. Over sedation with mechanically ventilated children in the PICU can have significant complications. Complications include withdrawal, risk for infection and increased the amount of time needed for assisted ventilation. With mechanical ventilation there is a need for adequate management of analgesia and sedation. There are various different ways to assess acceptable sedation and pain management. It is possible to utilize a sedation scale and pain scale that offers the best level of sedation and pain management for pediatric patients in the PICU. The COMFORT B Scale (CBS) is a tool used to assess behavioral and physiological items allowing research to offer strong evidence for the benefits and utilization (Recher et al., 2020). In the pediatric population there are multiple pain and sedation scales used to treat and identify pain while ensuring adequate sedation and the best care during the critical time spent in the intensive care unit. It is important for the medical staff caring for critical pediatric patients to have confidence in the pain and sedation scale being used is providing the best possible outcome for the children they are caring for. How do assessment tools compare to others? This motivates the question: In pediatric patients admitted to the pediatric intensive care unit (PICU) (P), how does the COMFORT B scale (I) compared to other sedation tools (C) affect adequate sedation and pain (O) during the PICU admission (T)?
With the advancement of technology and research, there are many very ill children requiring mechanical ventilation and sedation. PICUs across the world have reported 20-64% of children require a form of ventilation and critical care (Dorfman et al., 2014). This emphasizes the need for increased awareness of adequate sedation and pain management during this critical time. Pain and sedation assessment are the initial intervention to quality patient outcomes and pain management.
Date of publication
MSN Capstone Project
Masters of Science in Nursing - Education
Triana, Marsha K., "Pain and Sedation Scales in the Pediatric Intensive Care Unit" (2020). MSN Capstone Projects. Paper 64.