Patient-controlled and nurse-controlled analgesiaPPatient-controlled and nurse-controlled analgesiaPatient-controlled and nurse-controlled analgesiaEnglishPain/AnaesthesiaChild (0-12 years);Teen (13-18 years)NANADrug treatmentCaregivers Adult (19+)NA2017-03-17T04:00:00Z9.1000000000000058.20000000000001523.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Find out how PCA and NCA help your child get relief from severe, short-term pain in the hospital. </p><h2>What is analgesia?</h2><p>Analgesia is another name for pain relief. While your child recovers from surgery in the hospital, they may be given opioid medication such as <a href="/Article?contentid=194&language=English">morphine</a>, hydromorphone or <a href="/Article?contentid=135&language=English">fentanyl</a> to relieve severe, acute (short-term) pain. These drugs are usually used for a limited time.</p> <figure> <img alt="A machine with a hand-held button to provide pain medicine." src="https://assets.aboutkidshealth.ca/akhassets/PMD_PCA-NCA_Machine_EN.jpg" /> <figcaption class="asset-image-caption">A machine with a hand-held button to provide pain medicine.</figcaption> </figure><h2>Key points</h2> <ul> <li>Patient-controlled analgesia (PCA) and nurse-controlled analgesia (NCA) allow a child to receive opioid medication to relieve severe pain in hospital.</li> <li>PCA allows the patient to decide when and how much medication they receive. NCA is used if a patient cannot deliver their own medication.</li> <li>For safety reasons, only the patient should press the PCA button and only a nurse should press the NCA button.</li> <li>Sometimes, medications in PCA and NCA pumps can cause nausea, vomiting, constipation and drowsiness. Your child’s nurse will monitor your child closely to check for any side effects and make sure the medication is working properly.</li> </ul><h2>How do PCA and NCA work?</h2><p>For both PCA and NCA, medication is delivered through a special pump that is connected to an intravenous line (IV). This is a small tube put into a vein in your child’s arm or leg to give medicine or fluids. When a button attached to the pump is pressed, your child receives a small dose of medication through the IV line.</p><p>Usually your child will get pain relief right away, but other times it may take a few minutes for the medication to take effect.</p><p>The pump provides opioid medication in “as needed” doses, but it can also be programmed to provide a constant infusion, or flow, of opioid medication. You can ask your child’s nurse or a healthcare provider from your hospital’s pain service how your child’s pump is set up.</p><h2>How safe are PCA and NCA?</h2><p>When used properly, PCA and NCA therapy are very safe forms of pain relief. Two safety features built into the pump prevent your child from ever receiving too much medication.</p><ul><li>A lock-out period gives the medication time to work and prevents it from being delivered even if the button is pressed repeatedly.</li><li>A maximum dose setting (decided by your child’s health-care team) limits the total amount of medication your child receives.</li></ul><h2>How do I make sure my child uses PCA or NCA properly?</h2><h3>Patient-controlled analgesia</h3><ul><li>Only the patient (your child) decides when they need pain relief and pushes the button on the pump to deliver the medication. This is very important for safety reasons.</li><li>Your child should always be able to easily reach the button on their pump.</li><li>Your child can press the button before a painful activity or procedure, such as coughing, walking, physical therapy or dressing changes.</li><li>If, after one button push, the pain is not relieved in a few minutes, your child can press the button again.</li><li>If your child’s pain is not relieved after a few pushes, you or your child should let the nurse know.</li></ul> <figure> <img alt="A patient using a machine with a hand-held button to receive pain medicine." src="https://assets.aboutkidshealth.ca/akhassets/PMD_PatientControlledA_EN.jpg" /> <figcaption class="asset-image-caption">A patient using patient-controlled analgesia to receive pain medicine.</figcaption> </figure> <h3>Nurse-controlled analgesia</h3><ul><li>Only your child’s nurse pushes the button on the pump. This allows the nurse to monitor your child closely.</li></ul><h2>How effective are PCA and NCA?</h2><p>PCA and NCA offer fast and effective pain relief when they are used as instructed and for the exact pain for which they were prescribed.</p><p>Remember that they may not be helpful for other pains. For instance, the opioid medication in a PCA or NCA pump might not ease pain from a non-surgical headache or from stomach pain due to nausea or gas.</p><h3>Other options for pain relief</h3> <figure> <img alt="A nurse using a machine with a hand-held button to give a patient pain medicine." src="https://assets.aboutkidshealth.ca/akhassets/PMD_NurseControlledA_EN.jpg" /> <figcaption class="asset-image-caption">A nurse using nurse-controlled analgesia to provide pain medicine to a patient.</figcaption> </figure> <p>If your child experiences new or different pains, they may be prescribed other medications such as <a href="/Article?contentid=62&language=English">acetaminophen</a>, ketorolac (an intravenous anti-inflammatory medication) or <a href="/Article?contentid=153&language=English">ibuprofen</a>. If used correctly, these medications may help reduce the amount of opioid medication that your child needs.</p><h2>At SickKids</h2> <p>The Acute Pain Service (APS) is a team of pain specialists that looks after all patients with PCA and NCA and provides care to many other hospital patients who have pain. </p> <p>The service includes anaesthesiologists (doctors who provide sleep medicine and control pain for surgery, procedures and certain illnesses), advanced practice nurses and a psychiatrist. They work closely with other members of your child’s healthcare team to make sure your child’s pain is managed effectively.</p> <p>If you are using PCA or NCA, you can expect a daily visit from the APS. The team also has an anaesthesiologist on-call overnight to deal with any urgent concerns.</p>
Analgésie contrôlée par le patient et analgésie contrôlée par le personnel infirmierAAnalgésie contrôlée par le patient et analgésie contrôlée par le personnel infirmierPatient-controlled and nurse-controlled analgesiaFrenchPain/AnaesthesiaChild (0-12 years);Teen (13-18 years)NANADrug treatmentCaregivers Adult (19+)NA2017-03-17T04:00:00ZHealth (A-Z) - ProcedureHealth A-Z<p>Découvrez comment l’analgésie contrôlée par le patient (ACP) et l’analgésie contrôlée par le personnel infirmier (ACPI) peuvent soulager votre enfant de douleurs graves de courte durée à l’hôpital. </p><h2>Qu’est-ce qu’une analgésie?</h2><p>Une analgésie est une autre manière de désigner un soulagement de la douleur. Pendant que votre enfant se remet d’une intervention chirurgicale à l’hôpital, on lui administre des médicaments opioïdes comme la <a href="/Article?contentid=194&language=French">morphine</a>, l’hydromorphone ou le <a href="/Article?contentid=135&language=French">fentanyl</a> pour soulager ses douleurs graves et aiguës de courte durée. Ces médicaments sont généralement utilisés pendant une courte période.</p> <figure> <img src="https://assets.aboutkidshealth.ca/akhassets/PMD_PCA-NCA_Machine_EN.jpg" alt="" /> <figcaption class="asset-image-caption">Appareil muni d’un bouton portable pour administrer le médicament antidouleur.</figcaption> </figure><h2>À retenir</h2> <ul><li>L’analgésie contrôlée par le patient (ACP) et l’analgésie contrôlée par le personnel infirmier (ACPI) permettent à l’enfant de recevoir des opioïdes pour soulager des douleurs graves à l’hôpital.</li><li>L’ACP permet au patient de décider du moment et de la quantité de médicaments qu’il reçoit. L’ACPI est offerte lorsqu’un patient ne peut pas s’administrer lui-même ses médicaments.</li><li>Pour des raisons de sécurité, seul le patient doit presser le bouton d’ACP tout comme seul le personnel infirmier doit presser le bouton d’ACPI.</li><li>Les médicaments contenus dans les pompes d’ACP et d’ACPI peuvent provoquer des nausées, des vomissements, de la constipation et de la somnolence. L’infirmier de votre enfant surveillera de près la présence d’effets secondaires et s’assurera que le médicament fonctionne correctement.</li></ul><h2>Comment fonctionnent l’ACP et l’ACPI?</h2><p>Dans les deux cas, le médicament est administré au moyen d’une pompe spéciale connectée à une ligne intraveineuse appelée cathéter. Un petit tube est inséré dans une veine du bras ou de la jambe de votre enfant pour lui administrer des médicaments ou des liquides. Lorsque le bouton relié à la pompe est actionné, votre enfant reçoit une petite dose de médicaments à travers le cathéter.</p><p>Habituellement, votre enfant obtiendra un soulagement immédiat de la douleur, mais parfois, il se passera quelques minutes avant que le médicament fasse effet.</p><p>La pompe fournit les opioïdes « au besoin », mais elle peut également être programmée pour fournir une perfusion ou un débit constants de ces médicaments. Vous pourrez demander à l’infirmier de votre enfant ou à un fournisseur de soins de santé de la clinique de la douleur de l’hôpital de vous expliquer comment la pompe est mise en place.</p><h2>Quel est le degré de sécurité de l’ACP et l’ACPI?<br></h2><p>Utilisées correctement, l’ACP et l’ACPI sont des formes très sécuritaires de soulagement de la douleur. Deux dispositifs de sécurité intégrés dans la pompe évitent que votre enfant reçoive trop de médicaments.</p> Une fonction de verrouillage donne le temps au médicament d’agir, empêchant tout débit supplémentaire même si le bouton est pressé à plusieurs reprises. Une dose maximale, établie par l’équipe soignante de votre enfant, limite la quantité totale de médicaments que votre enfant reçoit. <p></p><h2>Comment puis-je m’assurer que mon enfant utilise une ACP ou une ACPI correctement?</h2><h3>Analgésie contrôlée par le patient</h3><ul><li>Seul le patient (votre enfant) décide du moment où il a besoin de soulager sa douleur et presse le bouton de la pompe pour recevoir le médicament. Cette possibilité est très importante pour des raisons de sécurité.</li><li>Votre enfant doit toujours être en mesure d’atteindre facilement le bouton de la pompe.</li><li>Il peut appuyer sur le bouton avant d’accomplir une tâche ou une procédure douloureuse, comme de tousser, de marcher ou de subir une physiothérapie ou un changement de pansement.</li><li>Si, après avoir pressé le bouton une fois, sa douleur ne diminue pas en quelques minutes, il pourra appuyer sur le bouton de nouveau.</li><li>Si la douleur de votre enfant persiste après quelques pressions, vous ou votre enfant devrez en informer l’infirmier.</li></ul> <figure> <img src="https://assets.aboutkidshealth.ca/akhassets/PMD_PatientControlledA_EN.jpg" alt="" /> <figcaption class="asset-image-caption">Patient en train d’utiliser l’appareil à l’aide d’un bouton portable pour recevoir le médicament antidouleur. </figcaption> </figure> <h3>Analgésie contrôlée par le personnel infirmier</h3><p>Seul le personnel infirmier de votre enfant peut presser le bouton de la pompe. Il peut ainsi surveiller de près votre enfant.</p><h2>Quelle est l’efficacité de l’ACP et l’ACPI?</h2><p>L’ACP et l’ACPI offrent un soulagement rapide et efficace de la douleur lorsqu’elles sont utilisées selon les instructions et pour la douleur exacte pour laquelle elles ont été prescrites.</p><p>Souvenez-vous qu’elles peuvent ne pas être utiles pour d’autres types de douleur. Par exemple, les opioïdes contenus dans une pompe d’ACP ou d’ACPI peuvent ne pas soulager des maux de tête non chirurgicaux ou des maux d’estomac liés à des nausées ou à des gaz.</p><h3>Autres options pour le soulagement de la douleur</h3> <figure><img src="https://assets.aboutkidshealth.ca/akhassets/PMD_NurseControlledA_EN.jpg" alt="" /><figcaption class="asset-image-caption">Infirmier en train d’utiliser une analgésie contrôlée par le personnel infirmier pour administrer un médicament antidouleur à un patient. </figcaption> </figure> <p>Si votre enfant présente toute nouvelle douleur, on pourra lui prescrire d’autres médicaments comme l’<a href="/Article?contentid=62&language=French">acétaminophène</a>, le kétorolac, un médicament anti-inflammatoire administré par voie intraveineuse, ou l’<a href="/Article?contentid=153&language=French">ibuprofène</a>. Utilisés correctement, ces médicaments peuvent aider à réduire la quantité d’opioïdes dont votre enfant a besoin.</p><h2>À l’Hôpital SickKids</h2> <p>Le Service de contrôle de la douleur aiguë est une équipe de spécialistes de la douleur qui s’occupe de patients qui font usage de l’ACP et de l’ACPI. Ce Service fournit aussi des soins à de nombreux autres patients de l’hôpital qui présentent de la douleur. </p><p>Le Service comprend des anesthésistes, des infirmiers en pratique avancée et un psychiatre. Les anesthésistes sont des médecins qui administrent les substances endormantes et qui contrôlent la douleur, soit lors d’une chirurgie ou lors de certaines interventions et de certaines maladies. Ces spécialistes travaillent en étroite collaboration avec les autres membres de l’équipe soignante de votre enfant pour s’assurer de bien gérer sa douleur.</p><p>Si vous avez recours à l’ACP ou à l’ACPI, attendez-vous à recevoir la visite du Service tous les jours. L’équipe dispose aussi d’un anesthésiste de garde la nuit pour traiter toute urgence.</p>

 

 

 

 

Patient-controlled and nurse-controlled analgesia2459.00000000000Patient-controlled and nurse-controlled analgesiaPatient-controlled and nurse-controlled analgesiaPEnglishPain/AnaesthesiaChild (0-12 years);Teen (13-18 years)NANADrug treatmentCaregivers Adult (19+)NA2017-03-17T04:00:00Z9.1000000000000058.20000000000001523.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Find out how PCA and NCA help your child get relief from severe, short-term pain in the hospital. </p><h2>What is analgesia?</h2><p>Analgesia is another name for pain relief. While your child recovers from surgery in the hospital, they may be given opioid medication such as <a href="/Article?contentid=194&language=English">morphine</a>, hydromorphone or <a href="/Article?contentid=135&language=English">fentanyl</a> to relieve severe, acute (short-term) pain. These drugs are usually used for a limited time.</p> <figure> <img alt="A machine with a hand-held button to provide pain medicine." src="https://assets.aboutkidshealth.ca/akhassets/PMD_PCA-NCA_Machine_EN.jpg" /> <figcaption class="asset-image-caption">A machine with a hand-held button to provide pain medicine.</figcaption> </figure><h2>How is the medication controlled?</h2> <p>The medication can be controlled through:</p> <ul> <li>patient-controlled analgesia (PCA)</li> <li>nurse-controlled analgesia (NCA)</li> </ul> <h3>Patient-controlled analgesia</h3> <p>With patient-controlled analgesia (PCA), the patient (your child) decides when they need medication to relieve their pain.</p> <h3>Nurse-controlled analgesia</h3> <p>With nurse-controlled analgesia (NCA), a nurse decides when your child receives pain relief. NCA is used when a patient needs to access pain medication quickly or frequently, but they cannot deliver it themselves, for instance because of their age, physical ability or developmental stage.</p><h2>Key points</h2> <ul> <li>Patient-controlled analgesia (PCA) and nurse-controlled analgesia (NCA) allow a child to receive opioid medication to relieve severe pain in hospital.</li> <li>PCA allows the patient to decide when and how much medication they receive. NCA is used if a patient cannot deliver their own medication.</li> <li>For safety reasons, only the patient should press the PCA button and only a nurse should press the NCA button.</li> <li>Sometimes, medications in PCA and NCA pumps can cause nausea, vomiting, constipation and drowsiness. Your child’s nurse will monitor your child closely to check for any side effects and make sure the medication is working properly.</li> </ul><h2>What can I do to help ease my child’s pain safely?</h2><p>Patients and family members play a very important role in pain management. </p><h3>Follow instructions</h3><p>It is very important that you follow all medication instructions from your child’s health-care team. Never press your child’s PCA or NCA button.</p><p> <i>Patient-controlled analgesia</i></p><p>For safety reasons, it is important that only your child pushes the PCA button. A patient who is asleep or drowsy should not receive any medication until they are alert enough to use the button on their own.</p><p> <i>Nurse-controlled analgesia</i></p><p>If your child uses NCA, it is important that only nurses press the button so they can monitor the effects of the medication on your child.</p><h3>Communicate with your child’s health-care team</h3><p>Tell your child’s nurse or the hospital’s pain service if your child’s pain is not being eased by the medication or if they are experiencing side effects.</p><p>Similarly, tell your child’s nurse if your child has any new or different pains so that your child can receive other treatments. </p><h3>Remind your child to use pain relief</h3><p>If your child is using PCA, remind them to push the button for pain relief when they need it.</p><h3>Use medications as part of the 3 P's of pain management</h3><p>Pain is often treated using the “3 P's of pain management”:</p><ul><li>pharmacological strategies (medications)</li><li>physical strategies </li><li>psychological strategies.</li></ul><p>Besides taking medications as instructed, your child can use physical strategies such as heat or cold packs, stretching, exercises, repositioning or massage. You can also encourage your child to manage their pain through psychological strategies such as distraction, playing games, deep breathing, meditation and guided imagery.</p><p>Together, the 3 P's can reduce your child’s pain and the impact of pain on your child’s time in hospital. Talk to your health-care team about how to build these strategies into your child’s pain management plan.</p><h2>How long will my child need to use PCA or NCA?</h2> <p>PCA and NCA are intended for short-term use. Your child will stop using them when:</p> <ul> <li>their pain has been relieved or </li> <li>they can take medication by mouth or through a feeding tube.</li> </ul> <p>Although it is not very common, PCA and NCA can sometimes be used for longer-term pain relief. Talk to your child's health-care team if you have questions about their specific therapy.<br></p><h2>How do PCA and NCA work?</h2><p>For both PCA and NCA, medication is delivered through a special pump that is connected to an intravenous line (IV). This is a small tube put into a vein in your child’s arm or leg to give medicine or fluids. When a button attached to the pump is pressed, your child receives a small dose of medication through the IV line.</p><p>Usually your child will get pain relief right away, but other times it may take a few minutes for the medication to take effect.</p><p>The pump provides opioid medication in “as needed” doses, but it can also be programmed to provide a constant infusion, or flow, of opioid medication. You can ask your child’s nurse or a healthcare provider from your hospital’s pain service how your child’s pump is set up.</p><h2>How safe are PCA and NCA?</h2><p>When used properly, PCA and NCA therapy are very safe forms of pain relief. Two safety features built into the pump prevent your child from ever receiving too much medication.</p><ul><li>A lock-out period gives the medication time to work and prevents it from being delivered even if the button is pressed repeatedly.</li><li>A maximum dose setting (decided by your child’s health-care team) limits the total amount of medication your child receives.</li></ul><h2>How do I make sure my child uses PCA or NCA properly?</h2><h3>Patient-controlled analgesia</h3><ul><li>Only the patient (your child) decides when they need pain relief and pushes the button on the pump to deliver the medication. This is very important for safety reasons.</li><li>Your child should always be able to easily reach the button on their pump.</li><li>Your child can press the button before a painful activity or procedure, such as coughing, walking, physical therapy or dressing changes.</li><li>If, after one button push, the pain is not relieved in a few minutes, your child can press the button again.</li><li>If your child’s pain is not relieved after a few pushes, you or your child should let the nurse know.</li></ul> <figure> <img alt="A patient using a machine with a hand-held button to receive pain medicine." src="https://assets.aboutkidshealth.ca/akhassets/PMD_PatientControlledA_EN.jpg" /> <figcaption class="asset-image-caption">A patient using patient-controlled analgesia to receive pain medicine.</figcaption> </figure> <h3>Nurse-controlled analgesia</h3><ul><li>Only your child’s nurse pushes the button on the pump. This allows the nurse to monitor your child closely.</li></ul><h2>How effective are PCA and NCA?</h2><p>PCA and NCA offer fast and effective pain relief when they are used as instructed and for the exact pain for which they were prescribed.</p><p>Remember that they may not be helpful for other pains. For instance, the opioid medication in a PCA or NCA pump might not ease pain from a non-surgical headache or from stomach pain due to nausea or gas.</p><h3>Other options for pain relief</h3> <figure> <img alt="A nurse using a machine with a hand-held button to give a patient pain medicine." src="https://assets.aboutkidshealth.ca/akhassets/PMD_NurseControlledA_EN.jpg" /> <figcaption class="asset-image-caption">A nurse using nurse-controlled analgesia to provide pain medicine to a patient.</figcaption> </figure> <p>If your child experiences new or different pains, they may be prescribed other medications such as <a href="/Article?contentid=62&language=English">acetaminophen</a>, ketorolac (an intravenous anti-inflammatory medication) or <a href="/Article?contentid=153&language=English">ibuprofen</a>. If used correctly, these medications may help reduce the amount of opioid medication that your child needs.</p><h2>Does the PCA or NCA medication have side effects?</h2><p>The side effects of opioid medication include:</p><ul><li>nausea and <a href="/Article?contentid=746&language=English">vomiting</a></li><li>constipation</li><li>itching</li><li>difficulty passing urine</li><li>drowsiness or slowed breathing.</li></ul><h3>Nausea and vomiting</h3><p>Opioids are most likely to cause nausea and vomiting. Your child’s healthcare team may prescribe other medications, such as dimenhydrinate (Gravol) or <a href="/Article?contentid=205&language=English">ondansetron</a> (Zofran), to help with this.</p><h3>Constipation</h3><p> <a href="/Article?contentid=6&language=English">Constipation</a> can be relieved with some medications. Drinking plenty of fluids and going for walks or doing some light exercise can also help.</p><h3>Itching</h3><p>Itching (especially around the face and chest) is a less common side effect of opioids. It may be managed with other medications or by changing the type of opioid medication in the PCA or NCA.</p><h3>Difficulty passing urine</h3><p>Less often, opioids can cause urinary retention (difficulty passing urine). This is sometimes treated by changing the dose or type of opioid medication. In rare cases, a child may need a urinary catheter to help empty the bladder.</p><h3>Drowsiness or slow breathing</h3><p>Sometimes, higher doses of opioids cause drowsiness or slow down breathing. Sleep is important for healing, but if it is difficult for your child to stay awake, especially right after using the PCA or NCA button, it is important to tell your child’s nurse.</p><h3>How will my child be monitored for side effects?</h3><p>Nurses closely monitor all patients who use PCA or NCA. Because the side effects of this medication include drowsiness and slowed breathing, your child’s pulse (heart beat) and oxygen saturation (the amount of oxygen in their blood) will be monitored constantly.</p><p>Your child’s nurse will also monitor for other medication side effects and check if the medication is working properly to reduce pain.</p><h2>At SickKids</h2> <p>The Acute Pain Service (APS) is a team of pain specialists that looks after all patients with PCA and NCA and provides care to many other hospital patients who have pain. </p> <p>The service includes anaesthesiologists (doctors who provide sleep medicine and control pain for surgery, procedures and certain illnesses), advanced practice nurses and a psychiatrist. They work closely with other members of your child’s healthcare team to make sure your child’s pain is managed effectively.</p> <p>If you are using PCA or NCA, you can expect a daily visit from the APS. The team also has an anaesthesiologist on-call overnight to deal with any urgent concerns.</p>Patient-controlled and nurse-controlled analgesiaFalse