@SapnaKmd talks on analgesia and sedation strategies using scores guidance

This is a key topic for all involved in caring for critically ill children

#WFPICCS20 #PedsICU #ICURehab
The question is asked: what impact does sedation strategy have on the developing brain?

We know that admission to #PedsICU can result in a constellation of features that impact on development

We cannot silo non-pharmacological interventions @SapnaKmd

#WFPICCS20 #ICURehab
The question is asked: what impact does sedation strategy have on the developing brain? We know that admission to #PedsICU can result in a constellation of features that impact on development We cannot silo non-pharmacological interventions @SapnaKmd #WFPICCS20 #ICURehab
The question is asked: what impact does sedation strategy have on the developing brain? We know that admission to #PedsICU can result in a constellation of features that impact on development We cannot silo non-pharmacological interventions @SapnaKmd #WFPICCS20 #ICURehab
This is a great slide @SapnaKmd

We worry about children on #PedsICU remembering their admission, loosing tubes/lines...

Choice of analgesia & sedation is key to address:
- pain/comfort
- delirium
- mobility
- family interaction

We need validated score systems

#WFPICCS20
@SapnaKmd tells us that whilst we may record sedation scores many of us do not use these to direct sedation management - why?!

By not sedating properly we have created a vicious cycle that leads to physiological dependence and delirium

#PedsICU #ICURehab #WFPICCS20
@SapnaKmd tells us that whilst we may record sedation scores many of us do not use these to direct sedation management - why?!By not sedating properly we have created a vicious cycle that leads to physiological dependence and delirium #PedsICU #ICURehab #WFPICCS20
@SapnaKmd tells us that whilst we may record sedation scores many of us do not use these to direct sedation management - why?!By not sedating properly we have created a vicious cycle that leads to physiological dependence and delirium #PedsICU #ICURehab #WFPICCS20
So what is the right framework to base sedation around?

@SapnaKmd shows us - implement analgesia FIRST, keeping the child calm and minimise the use of sedation

#PedsICU #WFPICCS20 #ICURehab
The first pharmacological agent to use should be analgesia and aim for pain control.

Using validated pain assessment tools is important - and they do exist in #pediatrics

Whilst self reported tools are gold standard most are patients are under 3

#PedsICU #WFPICCS20 #ICURehab
The first pharmacological agent to use should be analgesia and aim for pain control.Using validated pain assessment tools is important - and they do exist in #pediatrics Whilst self reported tools are gold standard most are patients are under 3 #PedsICU #WFPICCS20 #ICURehab
The first pharmacological agent to use should be analgesia and aim for pain control.Using validated pain assessment tools is important - and they do exist in #pediatrics Whilst self reported tools are gold standard most are patients are under 3 #PedsICU #WFPICCS20 #ICURehab
Obtaining #pain management is multimodal

Do not forget non-pharmacological methods!

#PedsICU #ICURehab #WFPICCS20 @SapnaKmd
Once analgesia is obtained then sedation can be considered

A key point @SapnaKmd tells us is that sedation requirments do not just vary between patients, but even within the individual patients #PedsICU admission

There are consequences to over sedation

#WFPICCS20 #ICURehab
Once analgesia is obtained then sedation can be considered A key point @SapnaKmd tells us is that sedation requirments do not just vary between patients, but even within the individual patients #PedsICU admission There are consequences to over sedation #WFPICCS20 #ICURehab
Once analgesia is obtained then sedation can be considered A key point @SapnaKmd tells us is that sedation requirments do not just vary between patients, but even within the individual patients #PedsICU admission There are consequences to over sedation #WFPICCS20 #ICURehab
Given the complexity of sedation in #PedsICU it is vital that we use sedation assessment tools

This allows targeting of optimal sedation, allows standardised communication between professionals and removes our own biases

@SapnaKmd shows us some tools

#ICURehab #WFPICCS20
Given the complexity of sedation in #PedsICU it is vital that we use sedation assessment toolsThis allows targeting of optimal sedation, allows standardised communication between professionals and removes our own biases @SapnaKmd shows us some tools #ICURehab #WFPICCS20
Given the complexity of sedation in #PedsICU it is vital that we use sedation assessment toolsThis allows targeting of optimal sedation, allows standardised communication between professionals and removes our own biases @SapnaKmd shows us some tools #ICURehab #WFPICCS20
Given the complexity of sedation in #PedsICU it is vital that we use sedation assessment toolsThis allows targeting of optimal sedation, allows standardised communication between professionals and removes our own biases @SapnaKmd shows us some tools #ICURehab #WFPICCS20
Given the complexity of sedation in #PedsICU it is vital that we use sedation assessment toolsThis allows targeting of optimal sedation, allows standardised communication between professionals and removes our own biases @SapnaKmd shows us some tools #ICURehab #WFPICCS20
@SapnaKmd discusses how to drive and introduce the use of sedation scores

It impacts on all members of the multidisciplinary team and the score should be discussed and reviewed on every shift

Using protocols may be beneficial

#WFPICCS20 #PedsICU
@SapnaKmd concludes her talk on analgesia and sedation in the #PedsICU for #WFPICCS20 conference

I would suggest you all listen to it! It’s on demand for 3 months.... thanks @WFPICCS

#ICURehab
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