use of sucrose i n paediatric immunisations l.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Use Of Sucrose I n Paediatric Immunisations PowerPoint Presentation
Download Presentation
Use Of Sucrose I n Paediatric Immunisations

Loading in 2 Seconds...

play fullscreen
1 / 18

Use Of Sucrose I n Paediatric Immunisations - PowerPoint PPT Presentation


  • 251 Views
  • Uploaded on

Use Of Sucrose I n Paediatric Immunisations. Dr Nadeem Akhtar . Non- Malificence. Key ethical principle in medicine Aim to do no harm Every effort should be made to minimise pain WHO refers to pain management as a fundamental human right . Painful Procedures. Venepuncture

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Use Of Sucrose I n Paediatric Immunisations' - krisalyn


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
non malificence
Non-Malificence
  • Key ethical principle in medicine
  • Aim to do no harm
  • Every effort should be made to minimise pain
  • WHO refers to pain management as a fundamental human right
painful procedures
Painful Procedures
  • Venepuncture
  • Cannulation
  • Injections
  • PAEDIATRIC IMMUNISATIONS
what can be done
What can be done?
  • Non pharmalogical
    • Freindley environment
    • Parental factors
    • Swaddling
    • Pacifiers
  • Pharmacological
    • Sucrose
evidence
Evidence
  • Cochrane review “
    • “Babies undergoing painful procedures need help to have their pain reduced”
    • “The review of trials found that giving sucrose to babies decreases their crying time and other pain indicators such as facial action”
evidence7
Evidence
  • Archieves of Paediatrics, Evidence based review
    • “All of the included studies reported that sucrose provided effective short-term pain management in children less than 24 months of age”
    • “for routine immunizations, a 24% oral sucrose solution was an effective analgesic”
evidence8
Evidence
  • Great Ormand Street Sucrose protocol
    • “Reduces distress associated with painful procedures”
    • “Is safe, and easily administered”
    • Recommend 24% Sucrose
    • Indications IM/SC injections
audit cycle 1
Audit Cycle 1
  • Audit current practice during routine paediatric immunisations against evidence
  • Aim observe 3 immunisations clinics (18 pts)
proforma
Proforma
  • Age
  • No. Of injections
  • Site
  • Vaccine used
  • Pharmacological method used ( Sucrose)
  • Non pharmacological methods used
  • Pain score
    • No response
    • Grimace
    • Cry
  • Nurse Score 0-10 (10 excellent)
results cycle 1
Results Cycle 1
  • 20 babies
  • Average age 18 weeks (range 12-52weeks)
  • Each baby received 2/3 IM injections
  • None received sucrose
  • 18 cried
  • 2 grimaced
  • Nurse average rating was 5.5
recommendations after cycle 1
Recommendations After Cycle 1
  • Aim to apply current evidence
  • Write up protocol
  • Training
  • Ensure materials available
    • Sucrose
    • Syringes
  • REAUDIT
audit cycle 2
Audit Cycle 2
  • Audit current practice during routine paediatric immunisations against evidence
  • Aim observe 3 immunisations clinics (18 pts)
proforma14
Proforma
  • Age
  • No. Of injections
  • Site
  • Vaccine used
  • Pharmacological method used ( Sucrose)
  • Non pharmacological methods used
  • Pain score
    • No response
    • Grimace
    • Cry
  • Nurse Score 0-10 (10 excellent)
results cycle 2
Results Cycle 2
  • 20 babies
  • Average age 16 weeks (range 9-24weeks)
  • Each baby received 2/3 IM injections
  • All babies recieved sucrose
  • 16 cried
  • 3 grimaced
  • 1 no response
  • Nurse average rating was 7.5
  • Crying time less
recommendations after cycle 2
Recommendations After Cycle 2
  • Evidence suggests sucrose works
  • Aim to continue to apply current evidence
  • Posters and leaflets to inform parents
  • Doctors to be trained and introduce idea of sucrose during baby checks
  • To share information with other practices and encourage the use of sucrose in all practices
  • REAUDIT
pro s con s
Pro’s & Con’s

Pro’s

  • Effective analgesia
  • Nurses and parents feel better
  • Evidence based practice

Con’s

  • Cost
  • Time
  • Consent
  • Other factors
thank you for listening
Thank You For Listening
  • 1. Dilli D, Küçük IZ, Dallar Y. Interventions to Reduce Pain during Vaccination in Infancy. JPediatr2008 Oct 10. [Epub ahead of print]. PubMed: PM18849052
  • 2. Hatfield LA, Gusic ME, Dyer AM, Polomano RC. Analgesic properties of oral sucrose during routine immunizations at 2 and 4 months of age. Pediatrics 2008;121(2):e327-e334.
  • 3. Hatfield LA. Sucrose decreases infant biobehavioral pain response to immunizations: a randomized controlled trial. J NursScholarsh 2008;40(3):219-25.
  • 4. Schechter NL, Zempsky WT, Cohen LL, McGrath PJ, McMurtry CM, Bright NS. Pain reduction during pediatric immunizations: evidence-based review and recommendations. Pediatrics2007;119(5):e1184-e1198
  • 5. Stevens B et al Sucrose for Analgesia in newborn infants undergoing painful procedures 2004 Cochrane Database Systematic review;

Any Questions?

References