Dear Colleagues, Thank you for being part of SPPM, a Society dedicated to “Better Care of Children in Pain.” Your work, engagement and the vital contributions to pediatric pain management have made a difference to children’s lives, but together we can strive to do even more. On this Giving Tuesday, November 28, 2023, when communities, organizations […]
QUESTION OF THE MONTH/VISUAL PEARLS/POLLS OF THE MONTH
November 2023 POLL OF THE MONTH
November 2023 QUESTION OF THE MONTH
A 3-month-old infant undergoes a Kasai procedure for biliary atresia. An epidural catheter was threaded from the caudal space to the thoracic level, and the position was confirmed by an epidurogram. On post-op day #1 the bedside nurse states that they do not think the epidural is working because the baby cries intermittently and sometimes appears uncomfortable. FLACC scores have been between 0-6. The baby has an NG tube in place, a right radial arterial line, and 2 peripheral IVs in the upper extremities.
Which of the following techniques is best for determining whether the epidural is functional or not?
A. Confirm the position of the epidural with Ultrasound
B. Use the Wong-Baker Faces Pain Scale in place of the FLACC
C. Check dermatome levels by gently palpating along the chest and abdomen
D. Stop the epidural and look for increased pain behavior