Page 267 - 2023 SMOG Digital

Pediatric PAIN MANAGEMENT

Vital Functions and Pain Scale
Signs and Symptoms:
• Tachycardia, Diaphoresis, Elevated Blood Pressure, Cry, Grimace, Splinting, Guarding

AVERAGE PEDIATRIC VITAL FUNCTIONS

Pediatric FLACC Pain Scale
(2 Months – 7 Years or Individuals Unable to Communicate)
Score of 5-10 = Moderate-Severe Pain, Consider Narcotic
Criteria 0 1 2
Face No particular Occasional grimace Frequent to
constant quivering
or frown, withdrawn,
expression or smile
uninterested chin, clenched jaw
Legs Normal position or Uneasy, restless, Kicking or legs
tense
relaxed
drawn up
In hemodynamically unstable or Lying quietly, normal Squirming, shifting, Arched, rigid or
inconsolable child, consider: Activity position, moves back and forth, tense jerking
Ketamine easily
(IV/IO Push over 1 min) No cry (awake or Moans or whimpers; Crying steadily,
• Analgesia: Cry asleep) occasional complaint screams or sobs,
IM / IN: 0.4mg/kg frequent complaints
IV / IO: 0.3mg/kg Reassured by
• Induction / Dissociative: Consolability Content, relaxed occasional touching, Difficult to console
IV / IO: 1-2mg/kg hugging or being or comfort
talked to, distractible
FENTANYL 0.5-2mcg/kg SIVP Acetaminophen 10-15mg/kg PO/PR
q20-30min (Max 4mcg/kg) Follow Procedural steps of:
PAIN MANAGEMENT GUIDELINE
Utilize Appropriate Medication in ONDANSETRON (for Nausea)
MORPHINE 0.1mg/kg IV SIVP/IM Pediatric Dose. • <40kg 0.1mg/kg IV
q120min (Max 0.4mg/kg) • >40kg 4mg IV
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