Painful procedures for patients with Hunter syndrome - IV access and blood sampling


  • Procedural pain
  • Assessment of pain
  • Prevention or reduction of pain

  • Hunter Syndrome Symptoms vary widelyranging from patient to patient. In addition to possible problems with the heart, lung, liver and other organs, musculoskeletal system, and brain lesions, many with Hunter syndrome have more pain than ordinary people. Often, due to the thick and tough skin, there are problems with access to the veins and blood sampling for laboratory analyzes. This article provides helpful suggestions on how to ease the procedure and reduce the pain associated with them. Some of these recommendations have been successfully used during elapraza infusion treatments at Children's Hospital and Research Center in Oakland.

    Pain - is an unpleasant sensory and emotionalsensation associated with actual or potential tissue damage, or described in terms of such damage. In other words, nurses and doctors should listen to each person and their opinion about the pain. The pain is real and against measures should be taken.

    Procedural pain

    Painful procedures for patients with Hunter syndrome - IV access and blood samplingProcedural pain of short durationand is associated with vmeshatelstvennym treatment or diagnostic tests, such as the insertion of a needle into the vein through the skin or lumbar puncture. If a painful procedure scheduled, the medical staff should explain that the pain should only last for a short time.

    People with Hunter syndrome damn needle into a veinor blood tests may be required more frequently than ordinary people. For example, the introduction of the needle into the vein requires much more than usual in the preparation of intravenous antibiotics or during surgical operations.

    Preparation for the procedure is important for children and patients with mental delay. Play therapy can be a valuable tool for children, often experiencing procedural pain.

    People are often faced with pain, oftenhave stronger behavioral and physical reactions because of the fear that it will happen. If you do not work with the child over his fears and perceptions of pain, it is likely that he will suffer in the future from undue stress and temporary behavioral changes.

    Assessment of pain

    It is desirable that the physician or nurse to know howchild responds to pain. It is important that parents are told to have this information. Most clinics have in their "arsenal" special means the degree of pain, for example FLACC scale, designed for young children, pain assessment scale Wong Baker, as well as a digital 10-point scale (from 0 to 10 points) pain assessment scale.

    Physical symptoms that may showthat the person is experiencing pain are heart palpitations, high blood pressure, deeper, or shortness of breath, sweating and pale complexion. However, even in the absence of these signs is no guarantee that the person does not feel pain. Change in behavior (changing facial expressions, restlessness, attracting the attention of the behavior, shouting or crying) usually occurs within a short period of time in the event of pain and often disappears quickly after the removal of the source of pain. Long irremovable pain can cause anxiety, irritability, depression, fatigue.

    Prevention or reduction of pain

    At moderate pain are encouraged to takemild analgesics like acetaminophen or non-steroid anti-inflammatory type ibuprofen preparations. In more severe pain is recommended that a combination of moderate analgesic and a strong opioid (a strong analgesic drugs). With the introduction of the needle into the vein and blood fence with success, local anesthesia can be used. Anesthetic gel helps with the local "prikozhnoy" pain, but can not help with the procedures, affecting the deeper tissues, such as lumbar punctures. Anesthetic gel should not be used in skin lesions or rash. It can not be used for infants who were born in a premature birth (less than 38 weeks). It is important to follow the recommendations on the use of drugs - onset and duration of drug action, its applicability for a particular procedure.

    Painful procedures for patients with Hunter syndrome - IV access and blood samplingSome non-medical procedures also allowsignificantly reduce pain. Warming hands or feet with warm blankets or hot water improves intravenous access, especially in the cold season. Drinking plenty of fluids the day before the procedure and the adoption of diuretics just before it improves blood circulation, making it easier IV access.

    In some cases it is necessary to do somepreventive procedures aimed, for example, to eliminate nausea or diarrhea. This will help the patient to relax, improve blood circulation and reduce his anxiety.

    Some patients have significantly better tolerate the procedure if smaller needle size used. This is due primarily to the fact that the skin in people with Hunter syndrome is more rigid.

    It is important to ensure a calm and soft atmosphere. If the patient is strong waves, it can embrace. This will help soothe the child and limit his movements. You can use all sorts of distractions means - television, video, toys. Praise for the patient and a small reward after the completion of the procedure will be long remembered and strongly baby Otten unpleasant painful experience in his mind.

    It is important to limit the maximum number of attempts to three. It is very important to have a trusting relationship with the patient. The clinic can be a lot of excellent specialists in carrying out the procedures associated with intravenous access, but usually only a limited number of specialists able to successfully carry out the procedure for a particular child.

    If the patient intravenous access muchdifficult, and it requires repeated procedures, it can be shown permanent central venous access, such as by means of Port-a-Cath silicone system.

    If insertion of the needle is successful, it is necessarytake measures to prevent it from accidentally falling out. The needle should be fixed with adhesive tape and the shroud. Very effective fixation of hoses and tubes to the patient's clothes with adhesive tape. You also need at least hourly observation of the skin where the needle was inserted, - may cause redness, swelling or pain.

    Termination procedures for intravenous anya child can be frightening and painful. Some patients may be hypersensitive skin, due to which removal of the needle, and particularly the removal belt can be quite painful. It was found that the area of ​​skin lubrication oil or water reduces pain.

    Effective control of pain increases the comfort,health and quality of life of patients. It is necessary to eliminate or reduce pain, reduce anxiety. It is important to remember that the perception of pain is very individual. The doctor and the family have to work with each patient. Communication, training, empathy significantly facilitate the carrying out of the procedure.

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