Questions about Pain

We have our own neonatal comfort score that a multi disciplinary commitee at my facility came up with. There are 5-6 parameters you assess and give a number value to each. If an infant scores greater than 3 we have to do an intervention and reassess in 30 minutes. We can do things such as give a pacifier, reposition, diaper change, prn med, scheduled med, hold, bundle. If an infant has surgery or orhwe invasive procedure we have to do a comfort assessment every 4 hours for the first 72 hours. On feeder/growers we do a comfort score at the beginning of each shift and no more unless they score above a 3. I normally do a comfort score with every assessment.

We usually use sweet ease with lab draws unless the baby is npo.

We also use NPASS, we just switched a few months ago and people are still getting used to it.

Typically try and use sucrose for sticks, unless they are NPO (which is a lot of times) Morphine or fentanyl for chest tubes/silo reductions. ECMO kids are usually on a couple of pain control drips (versed, morphine, valium etc) and if they are post op, they have scheduled or PRN morphine/fentanyl (depending on whether they are intubated).

You have to do at least one NPASS per shift (I usually try and do at arrival and when I leave for stable/non-pained kids) and every hour for sedation and pain if they are on a drip.