Comfort care measures:
Comfort care measures Handling techniques Gentle arousal ( talk softly and touch gently ) Gentle and minimal handling Warm hands when touching the baby Warm items that touch the baby Provide soothing intervention NNS ( non-nutritive sucking )- pacifier Containment ( hands on chest, legs tucked up) Kangaroo care ( skin to skin contact ) Swaddling
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Preterm Neonates ` <1,500 g: 0.05-0.3 mL. /dose given 2 minutes prior to procedure Preterm Neonates ROP EXAM 0.1mL orally 2 minutes Prior to procedure 0.1 mL orally at the Beginning of the procedure 0.1 mL orally 2 minutes after starting procedure Term Neonates >1,500g: 0.05- 2 mL/ dose once 2 minutes prior to procedure If yes, take steps to prevent procedural pain DO NOT Exceed 1 ml/day “ORAL SUCROSE”
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Give slowly into the side of the mouth 2 minutes prior to painful procedure to activate endogenous opioid system for release of endorphins Repeated dose : q 5mins Can be administered by dipping a pacifier into the sweet solution or by dropper directly to the tongue or buccal surface Document dose administered and effect of treatment. Chart in MAR as pacifier dips or as a volume: 1 drop =0.05ml 1 dip=about 0.1 ml If inadequate analgesia: Consider additional therapies to reduce pain Monitor for signs of pain relief : duration of crying facial grimacing motor activity heart rate change pain score oxygen saturation 24% sucrose ( sweet _ease or Toot sweet ) Oral dosage 1 Drop=0.05 ml
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Resources: www.medscape.com www.natus.com Neonatal Intensive Care Nursing 4 th edition©2010 neonatal networks ©2010 Hawaii Medical References: 1. Stevens,Yamada,Ohlsson .(2010) Sucrose for analgesia in newborn infants undergoing painful procedures. Cohrane Database of systematic reviews. 1,CD001069.pub3 1. 2. Carbajal,Danan,Nolent , et al ( 2008 )Epidemiology and treatment of painful procedures in neonates in intensive care units. Journal of the American Medical Association, 300,60-70 3. Beggs & Fitzgerald ( 2007 ). Development of peripheral and spinal nociceptive systems. Elsevier 4. Thompson,D.G . (2005). Utilizing an oral sucrose solution to minimize neonatal pain. Journal for Specialists in Pediatric Nursing, 10,3-10 5. Stevens,Yamada,Beyene,Gibbins , et al.(2005). Consistent management of repeated procedural pain with sucrose in preterm neonates: Is it effective and safe for repeated use over time? The Clinical Journal of Pain, 21, 543-548 Group Project by: ANNA LIZA DELA CRUZ, LINTA VINCENT, OLIVE MONTEMAYOR
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Thank you