Pediatric use of patient controlled analgesia
Patient controlled analgesia (PCA)
Some people think that pain is a normal part of the hospital experience and should be tolerated; but pain interferes with healing. That's why it's very important to control pain for all children.
Pain medicine can be given to your child in one of four ways: (1) by mouth, (2) into the bloodstream (intravenous or IV), (3) in the rectum, (4) or in the muscle (shot).
Research has shown that children tend to be more honest about the level of pain they are experiencing if they can avoid receiving a shot. So, at Children's Hospital of Iowa, we prefer to administer pain medication through an IV when possible.
One form of IV is Patient Controlled Analgesia (PCA). PCA is a safe and effective way for healthcare providers to manage your child's pain with the push of a button.
How does the PCA system work?
A small pump is attached to a stand near your child's bed. Inside the pump is a syringe filled with the pain medication that your doctor has ordered.
The syringe is attached to your child's IV. As your child recovers, there may be a small amount of medication running constantly through the IV. When you are aware that your child's pain is present or increasing, you or your child can push the button attached to the PCA pump to release an extra dose of medication.
How often can the button be pushed?
Push the button whenever your child has pain. A small amount of medication is immediately released to keep the pain under control; but don't worry, the machine is set to limit the amount of medication released, based on your doctors orders. If you see that your child's pain gets worse when he or she starts walking or doing breathing treatments, you can push the button for an extra dose of medication before beginning the activity.
If your child's pain is not being relieved, please tell your nurses or doctors, so they can consider changing the dose.
Is there danger of taking an overdose?
No. The PCA system can only give your child the amount of medication that has been prescribed. If your child pushes the button more often than the amount prescribed by the doctor, medication will not be released.
The PCA pump has many safety features including an alarm system. If your child drops the button or rolls over on it, the PCA pump will not release a dose of medication.
Will there be side effects?
Your child may feel some side effects from the PCA medication. A small number of children report feeling nauseous, itchy, or may have trouble passing urine or stool. If any of these symptoms occur, please notify your nurse or doctor.
What are the benefits of using PCA?
The PCA system gives children greater control over pain, helping them remain alert and supporting them as they recover. We think your child will like and benefit from using PCA. This system has been succcessfully used for children as young as three years of age. Your doctors and nurses will begin to take your child off of the PCA pump when your child is able to take oral pain medications.
Pediatric Nursing Division
University of Iowa Hospitals & Clinics
Peer Review Status: Internally Peer Reviewed