physical restraint in picu - page 2
hello everyone. on my picu in st. gallen, switzerland, we are attempting to develop a standard guideline for the use of physical restraint in ped. icu. we have based it on the american society for... Read More
Jan 11, '09Quote from janfrn[font="franklin gothic medium"]it would be even better if after i spend 2 hours pleading with our docs to give me extra sedation for my poor little intubated baby if the crazy mom would not come in the room, get in the baby's face, and holler "are you gonna wake up for mummum...come on, open those eyes!"but back to restraints in the picu. it would be very nice if anaesthesia brought the kids back in a state that would allow us to get them completely admitted before they tried to sit up.
Jan 11, '09I'm totally there with you kessadawn! And they still don't get it even after it's been explained to them why the kid shouldn't wake up. Makes me crazy.
Jan 21, '09Hi there!
I my experience, we use both sedation/pain scores (RASS,FLACC,FACES) to assess the adequacy of our sedation/pain management. We also require any means of restraint (soft wrist, Welcome sleeves) to be discussed and reordered every 24 hours. We also document the location, perfusion, skin integrity of the extremities restrained q2hrs.
Personally, if I have reliable parents, I will let them hold little hands and give them a break if I can. Drugs are great, but let's face it- these kids who are intubated for weeks at a time go through them like elephants. Pretty soon, we have kids on versed, fentanyl, dex, ketamine gtts along with hourly boluses of pentobard and the occasional ativan. So, what are we to do to keep our patients safe? Restraints are an ineviatable intervention, necessary, yet difficult.
One last thing, remember kids are easily distractable- so if the tolerate any kind of stimulation, soft music or familiar movies/TV shows. Good luck!