Show me how you feel by POINTING to the face.
3. Visual Analog Scale (VAS) (8 years of Age and Older)
On this chart the “0” means no pain, each number means a little more pain, and “10” means most pain possible.
You will choose a pain level for the child from the above scales. Based on the numbers, you will decide if the PCA button needs to be pushed (for pain medicine to be given to your child.)
When to Push the Button
Push the button when you are sure your child is having pain. If the child is old enough, ask him or her to use a pain scale.
Push the button before something painful happens, like a dressing change or when the child gets out of bed for the first few times. It is best to push the button about 10 minutes before the painful thing is going to happen.
When NOT to Push the Button
Do not push the button if the child is asleep or seems too groggy and has trouble staying awake.
The goal is to make the child as comfortable as possible, but it may not take away all of the pain. It is OK if he or she hurts a little with moving or coughing, but the pain should go back down when these things are stopped.
No caregiver other than you may push the button for the patient. This means that the patient or other family members may not push the button. Only the people approved to be Proxy and Proxy # 2 (a back-up person – usually your child’s nurse) may push the button.
DO NOT PUSH THE PCA BUTTON WHEN THE CHILD IS ASLEEP
Call your child’s nurse if the pain is not better after three (3) or more button pushes in one hour.
There is usually some sleepiness with pain medicine. If the child is too sleepy and hard to wake up, or breathing is shallow at night, you need to tell your nurse. The machine has a built-in limit, but pushing the button when the patient is asleep or too groggy can be dangerous. Following these rules will help keep your child safe.
Strong pain medicines (opioids) can have some serious side effects. If you see any of these tell your child’s nurse:
Sedation – too sleepy or groggy
Urinary retention – trouble passing urine
Respiratory depression – breathing too slow
Tolerance – getting used to the medicine so that it does not work as well
Allergic reactions – rash, hives, trouble breathing
The pain service will be managing the child’s pain medication. His or her nurse can contact the pain service 24 hours a day if needed to help with pain problems or side effects from the pain medicine.
REMEMBER: DO NOT PUSH THE BUTTON IF THE CHILD IS ASLEEP!
HH-V-260 6/16 Copyright 2016, Nationwide Children’s Hospital