Instruments for Scoring Pain, Non-Pain Related Distress, Analgesia, and Sedation in Pediatric Mechanically Ventilated Patients and their Efficacy and Effectiveness in Practice: A Systematic Review
Dedication This thesis is dedicated to my parents. ~For their endless love, support, and encouragement~ Abstract Objective pain and sedation assessment scales to standardize measures of distress in mechanically ventilated pediatric patients are increasingly available, but few have been evaluated for efficacy and effectiveness in this population. The purpose of paper one was to identify and evaluate available instruments appropriate for measuring physiological and behavioural cues of pain,
... cues of pain, non-pain related distress, and adequacy of sedation and analgesia in mechanically ventilated PICU or NICU patients. Twenty-eight articles were included in this systematic review, identifying 17 instruments. Three, additional, articles were found examining the efficacy and effectiveness of two of these scales in practice. In paper two, para-clinical tests used in the assessment of sedation (i.e. Bispectral Index Scale, auditory-evoked potential index, and skin conductance) were compared with three of the instruments for measuring sedation from paper one. Nine articles were identified in this systematic review and a correlation was found between the two methods for assessing sedation.