Table 2:
Most frequently performed painful procedures, arranged by pain severity, and pain management interventions administered to children who underwent these procedures*
| Pain severity rating; procedure | n | Type of pain management intervention; no. (%) of patients | Continuous opioid infusion | |||
|---|---|---|---|---|---|---|
| Pharmacologic only | Physical only | Psychologic only | Any type† | |||
| Mild | ||||||
| Suctioning: oral or nasal | 628 | 55 (8.8) | 3 (0.5) | 1 (0.2) | 60 (9.6) | 197 (31.4) |
| Removal of peripheral intravenous line | 534 | 6 (1.1) | 2 (0.4) | 0 (0.0) | 9 (1.7) | 52 (9.7) |
| Removal of urinary catheter | 193 | 5 (2.6) | 1 (0.5) | 0 (0.0) | 7 (3.6) | 53 (27.5) |
| Removal of nasogastric tube | 184 | 1 (0.5) | 0 (0.0) | 0 (0.0) | 1 (0.5) | 32 (17.4) |
| Scraping or swabs: nasopharyngeal | 108 | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 18 (16.7) |
| Removal of peripheral arterial line | 91 | 14 (15.4) | 2 (2.2) | 0 (0.0) | 16 (17.6) | 33 (36.3) |
| Removal of central venous line | 64 | 8 (12.5) | 0 (0.0) | 0 (0.0) | 9 (14.1) | 22 (34.4) |
| Accessing implantable venous port | 35 | 5 (14.3) | 0 (0.0) | 0 (0.0) | 7 (20.0) | 3 (8.6) |
| Mild to moderate | ||||||
| Capillary sampling | 896 | 42 (4.7) | 3 (0.3) | 0 (0.0) | 47 (5.2) | 69 (7.7) |
| Suctioning: endotracheal | 575 | 90 (15.7) | 0 (0.0) | 0 (0.0) | 91 (15.8) | 255 (44.3) |
| Dressing change or removal | 535 | 59 (11.0) | 9 (1.7) | 1 (0.2) | 72 (13.5) | 92 (17.2) |
| Mobilization | 364 | 89 (24.5) | 1 (0.3) | 0 (0.0) | 94 (25.8) | 92 (25.3) |
| Injection: subcutaneous | 234 | 24 (10.3) | 4 (1.7) | 0 (0.0) | 29 (12.4) | 20 (8.6) |
| Removal of endotracheal tube | 199 | 29 (14.6) | 0 (0.0) | 0 (0.0) | 29 (14.6) | 71 (35.7) |
| Removal of tape from skin | 191 | 10 (5.2) | 0 (0.0) | 0 (0.0) | 10 (5.2) | 24 (12.6) |
| Insertion of nasogastric tube‡ | 180 | 7 (3.9) | 2 (1.1) | 1 (0.6) | 11 (6.1) | 37 (20.6) |
| Scraping or swabs: for culture or specimen | 109 | 2 (1.8) | 0 (0.0) | 0 (0.0) | 2 (1.8) | 18 (16.5) |
| Tracheotomy care | 55 | 2 (3.6) | 0 (0.0) | 0 (0.0) | 2 (3.6) | 9 (16.4) |
| Repositioning or restrapping of endotracheal tube | 45 | 16 (35.6) | 0 (0.0) | 0 (0.0) | 16 (35.6) | 27 (60.0) |
| Suctioning: tracheotomy | 34 | 2 (5.9) | 0 (0.0) | 0 (0.0) | 2 (5.9) | 4 (11.8) |
| Wound irrigation | 31 | 2 (6.5) | 0 (0.0) | 0 (0.0) | 2 (6.5) | 8 (25.8) |
| Moderate to severe | ||||||
| Venipuncture or phlebotomy | 771 | 23 (3.0) | 4 (0.5) | 1 (0.1) | 29 (3.8) | 84 (10.9) |
| Insertion of peripheral intravenous line‡ | 410 | 32 (7.8) | 3 (0.7) | 0 (0.0) | 36 (8.8) | 46 (11.2) |
| Insertion of urinary catheter‡ or suprapubic aspiration | 136 | 5 (3.7) | 0 (0.0) | 0 (0.0) | 5 (3.7) | 31 (22.8) |
| Cleaning or care of excoriated skin | 130 | 22 (16.9) | 18 (13.8) | 0 (0.0) | 43 (33.1) | 13 (10.0) |
| Insertion of endotracheal tube‡ | 103 | 84 (81.6) | 0 (0.0) | 0 (0.0) | 85 (82.5) | 22 (21.4) |
| Insertion of peripheral arterial line‡ | 83 | 25 (30.1) | 0 (0.0) | 0 (0.0) | 25 (30.1) | 18 (21.7) |
| Removal of chest tube | 56 | 35 (62.5) | 0 (0.0) | 0 (0.0) | 35 (62.5) | 19 (33.9) |
| Insertion of peripherally inserted central catheter‡ | 56 | 37 (66.1) | 0 (0.0) | 0 (0.0) | 39 (69.6) | 9 (16.1) |
| Lumbar puncture‡ | 49 | 25 (51.0) | 0 (0.0) | 0 (0.0) | 28 (57.1) | 4 (8.2) |
| Endoscopy | 43 | 36 (83.7) | 0 (0.0) | 0 (0.0) | 36 (83.7) | 3 (7.0) |
| Insertion of nasojejunal tube‡ | 40 | 11 (27.5) | 0 (0.0) | 0 (0.0) | 11 (27.5) | 11 (27.5) |
| Insertion of central venous line‡ | 39 | 22 (56.4) | 0 (0.0) | 0 (0.0) | 22 (56.4) | 12 (30.8) |
| Injection: intramuscular | 35 | 10 (28.6) | 0 (0.0) | 0 (0.0) | 10 (28.6) | 1 (2.9) |
*
Data for both procedures and interventions relate to the 24-hour period before data collection, but interventions were not necessarily administered for the procedures recorded. The table does not include procedures administered to less than 1% of the study population.
†
Alone or in combination. There were no patients who received all three types of intervention (pharmacologic, physical and psychologic).
‡
Includes unsuccessful attempts.