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Paeds Casesinvestigations-procedures-and-technology

Paeds Cases · investigations-procedures-and-technology

Plan a comfort bundle for an infant cannulation — OSCE

OSCE communication and planning station: assess a 6-month-old infant before a venepuncture and cannulation, choose and time the topical anaesthetic, plan the multi-modal comfort bundle (sucrose or breastfeeding, distraction, comfort positioning), counsel the anxious parent, and outline when to escalate to procedural sedation.

communication and procedural-planning station2 min readVerification in progress

Target exams

RACP DCEMRCPCH ClinicalRCPSC PediatricsABP General Pediatrics
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Study tools

Target exams

RACP DCEMRCPCH ClinicalRCPSC PediatricsABP General Pediatrics
Prompt
A 6-month-old previously well infant is brought to the emergency department with a febrile illness and requires a venepuncture and cannulation. The infant is alert and being nursed by the mother, who is visibly anxious about her baby being hurt. The team has about 70 minutes before the bloods are due. You are the paediatric registrar asked to assess the child and plan the procedural comfort bundle, explaining it to the parent.

Candidate brief

You have this station to assess a 6-month-old infant before a venepuncture and cannulation, choose and time the topical anaesthetic, plan the multi-modal comfort bundle, and counsel the anxious parent. Treat this as a calm, planned procedure with time to prepare, and explain each layer of the bundle to the mother in plain language. State explicitly how you would dose and time oral sucrose if breastfeeding is not used, and how you would position the child. [1] [9]

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References4ShowHide
  1. [1]Pillai Riddell RR, Bucsea O, Shiff I, et al Non-pharmacological management of infant and young child procedural pain Cochrane Database Syst Rev, 2023.PMID 37314064
  2. [2]Foster JP, Taylor C, Spence K Topical anaesthesia for needle-related pain in newborn infants Cochrane Database Syst Rev, 2017.PMID 28160271
  3. [3]Yamada J, Bueno M, Santos L, et al Sucrose analgesia for heel-lance procedures in neonates Cochrane Database Syst Rev, 2023.PMID 37655530
  4. [9]Friedrichsdorf SJ, Eull D, Weidner C, et al A hospital-wide initiative to eliminate or reduce needle pain in children using lean methodology Pain Rep, 2018.PMID 30324169
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