What do you use for pain control for PICC insertions?

  1. 0 We use oral sucrose for minor painful procedures, such as heelsticks and PIV insertions. Sometimes oral sucrose is enough to keep an infant comfortable during a PICC insertion, but with the bigger infants it just doesn't do it. Our doctors don't want to prescribe even a single low dose of morphine for those babies that are pulling away and crying. What do you use? Is there something between oral sucrose and morphine?
  2. Visit  ICN_RN profile page

    About ICN_RN

    Joined Jan '10; Posts: 1.

    11 Comments so far...

  3. Visit  Mimi2RN profile page
    0
    Our PICC orders are for Fentanyl or Morphine, but sometimes they don't need anything and sometimes the meds don't seem to help at all.
  4. Visit  tunafish1800 profile page
    0
    Lidocaine? Emla cm a topical numbing agent is all I've ever used
  5. Visit  dawngloves profile page
    0
    Fentanyl
  6. Visit  NeoNurseTX profile page
    0
    Morphine sometimes
  7. Visit  jwendt profile page
    0
    We give Versed and that seems to cover most babies. Some need a second dose.
  8. Visit  Julie Basilio profile page
    0
    stat dose of Fentanyl!
  9. Visit  littleneoRN profile page
    0
    Fentanyl and Versed always unless they don't have any other access in which to give it. May possibly be redosed if no effect depending on the baby.
  10. Visit  LoveTheNICU profile page
    2
    As a newer NNP, I came into a practice where the "more experienced" NNPs tended to restrain the infants hand and foot and give sucrose for PICC insertions. A few of the newer girls and I have adopted an approach that includes swaddling the infant with only the necessary extremity left out, as well as sucrose administration and Fentanyl if the infant requires it. If I can fairly confidently say that I will be able to insert the PICC with one stick, I may forgo the Fentanyl if the infant is otherwise calm and contained by the swaddling, however I tend to err on the side of giving the dose rather than witholding it. I have also occasionally given oral or intranasal Versed to an infant lacking other IV access. On a side note- some of the "more experienced" NNPs can't figure out why we have a higher percentage of successful insertions, and can perform them more quickly... Hmmm....
    Tina1639 and karnicurnc like this.
  11. Visit  BittyBabyGrower profile page
    0
    Fentanyl or nasal versed if no IV access.
  12. Visit  karnicurnc profile page
    0
    Sucrose, swaddling, Fentanyl, Versed.
  13. Visit  EmilyPeruana profile page
    0
    we ALWAYS use fentanyl...sometimes versed too...on the larger kids, sometimes sucrose too...


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