Analgesics and sedatives (peds): Difference between revisions
No edit summary |
|||
| Line 1: | Line 1: | ||
==Introduction== | ==Introduction== | ||
Analgesia and sedation considerations, particularly in the nonverbal population, requires a more careful approach than typically needed in the adult population. Children may require sedation for procedures that are done with topical anesthetic in the adult population and evaluation of pain in infants and young children can be challenging. This page contains considerations for evaluation, options for anesthesia and sedation, and dosages for common analgesics. | Analgesia and sedation considerations, particularly in the nonverbal population, requires a more careful approach than typically needed in the adult population. Children may require sedation for procedures that are done with topical anesthetic in the adult population and evaluation of pain in infants and young children can be challenging. This page contains considerations for evaluation, options for anesthesia and sedation, and dosages for common analgesics and sedatives. | ||
==Evaluation== | |||
There are a number of well established frameworks for evaluating pain that are helpful in the pediatric ED. Which framework works best is dependent on the age of the patient and provider preference. | |||
===Neonates=== | |||
CRIES Scale (used to establish baseline and assess discomfort over time): | |||
C = Crying | |||
R = Requires O2 | |||
I = Increased Vital Signs | |||
E = Expression | |||
S = Sleeplessness | |||
==Pediatric doses for Common Analgesics== | ==Pediatric doses for Common Analgesics== | ||
| Line 42: | Line 52: | ||
*PO: 0.05-0.15mg/kg/dose of oxycodone 14-6hrs | *PO: 0.05-0.15mg/kg/dose of oxycodone 14-6hrs | ||
==Sedatives== | ==Pediatric doses for Common Sedatives== | ||
[[Midazolam]] | [[Midazolam]] | ||
*IM: 0.05-0.15mg/kg; max 10mg | *IM: 0.05-0.15mg/kg; max 10mg | ||
Revision as of 16:21, 14 October 2022
Introduction
Analgesia and sedation considerations, particularly in the nonverbal population, requires a more careful approach than typically needed in the adult population. Children may require sedation for procedures that are done with topical anesthetic in the adult population and evaluation of pain in infants and young children can be challenging. This page contains considerations for evaluation, options for anesthesia and sedation, and dosages for common analgesics and sedatives.
Evaluation
There are a number of well established frameworks for evaluating pain that are helpful in the pediatric ED. Which framework works best is dependent on the age of the patient and provider preference.
Neonates
CRIES Scale (used to establish baseline and assess discomfort over time): C = Crying R = Requires O2 I = Increased Vital Signs E = Expression S = Sleeplessness
Pediatric doses for Common Analgesics
Non-Opioid
- PO/PR: 10-15mg/kg/dose q4-6hrs
- Children’s Tylenol is 160mg/5ml
- Max: 75mg/kg/day or 4000mg/day
- PO: 4-10mg/kg/dose q6-8hrs
- Children’s Motrin is 100mg/5ml
- Max: 40mg/kg/day
- IM/IV: 0.5mg/kg/dose q6hrs
- PO: 1-2mg/kg/dose q4-6hrs
Opioid
Naloxone (opioid overdose reversal)
- IV/IM: 0.001-0.02mg/kg/dose
- IM/IV: 0.05-0.2mg/kg/dose q2-4hrs
- IV: 0.015mg/kg/dose q4-6hrs
- PO: 0.03-0.08mg/kg/dose q3-4hrs
- IV: 1-2 mcg/kg/dose q1-2hrs
- IN: 1-2 mcg/kg/dose via atomizer
- PO: 0.05-0.15mg/kg/dose q4-6hrs
- PO: 0.5=1mg/kg/dose q4-6hrs
- IV/PO: 0.05-0.1mg/kg/dose q6hrs
Combination Medication
Acetaminophen with Codeine
- PO: 0.5-1mg/kg/dose of codeine q4-6hrs
Acetaminophen with Hydrocodone
- PO: 0.15mg/kg/dose of hydrocodone q4-6hrs
Acetaminophen with Oxycodone
- PO: 0.05-0.15mg/kg/dose of oxycodone 14-6hrs
Pediatric doses for Common Sedatives
- IM: 0.05-0.15mg/kg; max 10mg
- IV:
- 6mo-5yr: 0.05-0.1mg/kg initially with up to 0.6mg/kg needed; max 6mg
- 6yr-12yr: 0.025-0.05mg/kg initially with up to 0.4mg/kg needed; max 10mg
- 12yr-16yr:1-2mg initially with up to 2.4-5mg needed; max 10mg
- PO: 0.25-0.5mg/kg; max 20mg
- IV/PO: 0.05-0.1mg/kg q4-8hrs
- IV: 0.5-2mg/kg
- IM: 3-7mg/kg
- PO: 25-50mg/kg
- IV: 1-2mg/kg over 30 seconds
- IV: 0.3mg/kg