Pediatric rating scales

brithoover · Mar 23, 2013

We use FLACC, faces and 1-10 scales for pain. We also do a falls risk assessment for all ages and an ESE assessment which is basically an entanglement risk

aeronursenj · Mar 23, 2013

We use NIPS , Flaccs, Faces and Numerical (based on the age/ mental status of the child) in the ER. I am not sure if they have a fall scale on our peds floor, but it makes me wonder now. I have to check it out.

AeronurseNJ

KelRN215, BSN, RN · Mar 23, 2013

FLACC is definitely the pain scale of preference for younger children and older children who are developmentally delayed.

umcRN, BSN, RN · Mar 24, 2013

We use FLACC, faces and 1-10 scales for pain. We also do a falls risk assessment for all ages and an ESE assessment which is basically an entanglement risk

Entanglement? That sounds interesting! What do you do for a high score? I work ICU so don't have this problem too often but occasionally we get those movers who I'm worried are going to be strangled if their not watched 24/7

brithoover · Mar 24, 2013

Entanglement? That sounds interesting! What do you do for a high score? I work ICU so don't have this problem too often but occasionally we get those movers who I'm worried are going to be strangled if their not watched 24/7

We assess based on age, activity, and have an iv or tube of any kind automatically scores them 2 points. Among other things. If they are high risk a patent must be with them at all times and we would check in on them more often

umcRN, BSN, RN · Mar 24, 2013

We assess based on age, activity, and have an iv or tube of any kind automatically scores them 2 points. Among other things. If they are high risk a patent must be with them at all times and we would check in on them more often

So a 13 month old with 5 continuous IV's, continuous g-tube feeds and continuous tele/sat monitoring would be pretty high risk :yes: haha stopped that kid from hanging himself a few times. Unfortunately we cannot mandate that a parent stays with a child 24/7, especially when the child has been in the hospital for 6 months.

brithoover · Mar 24, 2013

So a 13 month old with 5 continuous IV's, continuous g-tube feeds and continuous tele/sat monitoring would be pretty high risk haha stopped that kid from hanging himself a few times. Unfortunately we cannot mandate that a parent stays with a child 24/7, especially when the child has been in the hospital for 6 months.

Lol yes that is about as high risk as they get. I'm not sure what they do in our ICU, I'm in oncology but all of our parents stay overnight. Our new AMLs are in the hospital for their first 6 months of treatment

Pediatric Critical Care Columnist · Mar 24, 2013

Entanglement assessments are standard protocol on our peds floors. About a dozen years ago one of our kids was accidentally strangled with IV tubing while an inpatient on one of the floors.

Strangulation With Intravenous Tubing: A Previously Undescribed Adverse Advent in Children

http://www.saskatoonhealthregion.ca/about_us/documents/Nursing%20Affairs/Prevention_of_Entangelement_Strangulation_ESE_and_Falls-Pediatrics-1063.pdf

umcRN, BSN, RN · Mar 25, 2013

Yes I can definitely see the importance of it...interesting. I'm on my units practice council. Maybe something to be brought up.

That's pretty impressive you can always guarantee a parent at the bedside! How do they manage their work/other children? We certinaly have our parents that never leave but sometimes they just have to spend a night away, even if only for their sanity. Just curious.

brithoover · Mar 25, 2013

Yes I can definitely see the importance of it...interesting. I'm on my units practice council. Maybe something to be brought up.
That's pretty impressive you can always guarantee a parent at the bedside! How do they manage their work/other children? We certinaly have our parents that never leave but sometimes they just have to spend a night away, even if only for their sanity. Just curious.

To be honest I'm new to this unit: peds oncology. Been on the floor for about 1.5 mths and I have yet to see a child spend the night alone. It becomes a major stress financially, the other kids don't seem to become priority. It's extremely sad situation. These parents feel as though if they leave their child for any length of time they might die while they are gone

umcRN, BSN, RN · Mar 25, 2013

To be honest I'm new to this unit: peds oncology. Been on the floor for about 1.5 mths and I have yet to see a child spend the night alone. It becomes a major stress financially, the other kids don't seem to become priority. It's extremely sad situation. These parents feel as though if they leave their child for any length of time they might die while they are gone

Well I can see that side of it, especially in a cardiac ICU where a child can be sitting up talking to you one minute, and coding the next (exactly how my first code went, came out of nowhere) so parents have a hard time leaving. However I feel as though that must be very stressful personally and not healthy. Everyone needs a break out of the hospital now and then, a night in their own beds. We encourage parents to take nights off, most do, some don't but we try to create an environment where parents are ok leaving their child for a few hours or a night, especially for the sake of other children who are not allowed in the ICU 24/7.