Techniques to Reduce Procedural Pain and Anxiety: The Experience of a High Volume Tertiary Pediatric Emergency Department - EAP 2019 Congress and MasterCourse Porto Palacio Hotel

Background and Objective: A substantial number of children seen in the paediatric emergency department require procedures which often leads to pain and anxiety. This can be distressing for both children and parents. This is a descriptive study of the methods used to reduce procedure pain and anxiety in paediatric patients to a tolerable level to facilitate procedures.

Methods: We review the methods of procedural pain control in a high-volume tertiary pediatric emergency department in Singapore. A range of pharmacological and non-pharmacological methods are used, depending on the age of the patient and type of procedure required.

Results: Age-specific methods of to relieve pain during painful procedures are effective. For neonates, this can include swaddling, oral glucose administration, non-nutritive sucking on a pacifier. For older children, distraction methods and parental presence can be useful in minor procedures like venipucture and intravenous cannulation. For procedures like laceration repair, manipulation and reduction of fractures, pharmacologic methods can be deployed in the form of local anesthesia or conscious sedation. Parental education in the form of direct communication between healthcare providers and parents, along with the use of patient education brochures leads to better preparedness for painful procedures.

Conclusion: A combination of non-pharmacological and pharmacological methods to reduce procedural pain and anxiety, together with parental education can lead to overall improved patient experience.