1. THE PAIN FREE PEDIATRIC EMERGENCY DEPARTMENT FACLP 2012 Presented by: Samantha Leahy MA CCLS III Inova Loudoun Hospital Samantha.Leahy@inova.org P) 703-858-6544

2. The Problem…  Child’s Panic  Parent’s Panic  Staff’s Panic

3. The Idea…  Can we make the ED PAIN FREE?

4. Research  Studies have shown that pain in young children has lifelong psychological effects, and memories of pain can lead to delayed medical care for people in their later years (Madhok, 2011).

5. Three Big Questions Can medications be administered in a pain free way? Can medications be administered in a pain free way? Are the non IV medications as effective as IV medications? Are the non IV medications as effective as IV medications? Does it affect our patient satisfaction scores? Does it affect our patient satisfaction scores?

6. Medication Trials LMX vs. IV without numbing cream LMX vs. IV without numbing cream LET vs. sutures with injectable medications LET vs. sutures with injectable medications Sutures with buffered vs. regular lidocaine Sutures with buffered vs. regular lidocaine JTIP and Freeze spray JTIP and Freeze spray Intranasal Fentanyl Intranasal Fentanyl

7. Results  What do you think happened?

8. Group Discussion  What has your hospital used?  Did it work?  What didn’t work?  What would you like to try in the future?

9. Questions?

10. References  1. Adler, AJ, Dubinsky, L. “Does the Use of Topical Lidocaine, Epinephrine, and Tetracaine Solution Provide Sufficient Anesthesia for Laceration Repair?” Academic Emergency Medicine. 1998 Feb; 5(2): 108-112. Print.  2. Madhok, Manu, Michael Scribner – O’Pray, Mindy Teele. “Managing Pediatric Pain in Minor Injuries.” Contemporary Pediatrics. June (2011). Print.  3. “No Need For a Lollipop”. The Newsweek. 18 October 1998. Print.  4. Resch, Karen, Craig Schilling, et al. “Topical Anesthesia for Pediatric Lacerations: A Randomized Trial of Lidocaine- Epinephrine-Tetracaine Solution Versus Gel.” Annals of Emergency Medicine. 32.6 (1998).