My friend and former division chief Dr. Jim Besunder talks about evidence based assessment of pain and agitation #SCCM2022 #PedsICU #PANDEM
1/
Besunder - while self report is the gold standard, the age, acuity and interventions of the #PedsICU patient make this often not useful. Many other tools aren't validated in the population. 2 that work well are Oucher and Wong Baker #SCCM2022
2/
The guidelines recommend using self report tools when possible, the FLACC or COMFORT-B in non-communicative patients. Avoid use of VS alone to assess pain. #SCCM2022 #PedsICU
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Besunder - Recommendation for sedation and agitation had strong recommendation for SBS or COMFORT-B, but only conditional recommendation for RASS.
#SCCM2022 #PedsICU
4/
Besunder - Recommend bundled care approach with targeted sedation and re-assessment at least once daily, consider sedation weaning protocol, assure adequate nursing care to monitor more closely as patients sedation level lightens
#SCCM2022 #PedsICU
5/5
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