Issues in comprehensive pediatric nursing
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Issues Compr Pediatr Nurs · Jan 2009
Randomized Controlled TrialFamily exemplars during implementation of a home pain management intervention.
Postoperative pain and symptom management at home following pediatric tonsillectomy and adenoidectomy (T & A) is challenging. There are few randomized clinical trials that have established postoperative care interventions that are specific and effective during home recovery. The purpose of this pilot feasibility study was to describe how children and their families implemented a randomly assigned alarm intervention designed to promote postoperative around-the-clock administration of analgesics. ⋯ Themes that emerged from the qualitative analysis of the interviews included painful challenges; struggling with decisions; making things work; a lengthy recovery; and family support. Results supported the need for research to establish evidenced-based home care interventions specific for T & A postoperative recovery. Mothers and children suggested the need for education and support that extends longer into the recovery period.
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Issues Compr Pediatr Nurs · Jan 2009
Atraumatic care: EMLA cream and application of heat to facilitate peripheral venous cannulation in children.
The purpose of this study was to investigate whether the application of heat placed to a child's potential intravenous (IV) site after the application of EMLA Cream™ decreases vasoconstriction, therefore promoting atraumatic care in the hospitalized pediatric patient. Venipuncture in children is a painful and frequently performed procedure. While use of EMLA Cream™ to reduce pain on insertion is a common practice with pediatric patients, no studies had measured venous size in relation to EMLA Cream™ and heat application. ⋯ Mean vein measurements were 0.243 cm prior to EMLA Cream™, 0.205 cm after EMLA Cream™ applied for 1 hour, and 0.253 cm after two minutes of heat. There was a significant increase in vein visualization from pre-application of heat to post application of heat with a success rate of 80% with the first time attempt of IV insertion. Therefore, application of heat counteracts the adverse effect of vasoconstriction that occurs with EMLA Cream™ application, potentially increasing peripheral venous cannulation success rates.