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?

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  2. 11 Comments...

  3. 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. 0
    Lidocaine? Emla cm a topical numbing agent is all I've ever used
  5. 0
  6. 0
    Morphine sometimes
  7. 0
    We give Versed and that seems to cover most babies. Some need a second dose.
  8. 0
    stat dose of Fentanyl!
  9. 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. 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. 0
    Fentanyl or nasal versed if no IV access.

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