Management of Pain, Anxiety, and Delirium in Critically Injured Pediatric Trauma Patients

Review recent advances in pain, sedation, and delirium management in the pediatric intensive care unit (PICU) and how they may benefit critically injured pediatric trauma patients.

Multiple retrospective studies of pediatric trauma patients show high rates of inadequate analgesia in the acute setting and increased delirium rates compared with the overall PICU population. Recent pediatric critical care guidelines emphasize early identification with validated assessment tools and goal-directed care protocols incorporating pharmacologic and non-pharmacologic measures to address pain and sedation. However, studies specific to pediatric trauma patients are needed to inform best practices for this unique patient population.

PICU-specific care bundles have been beneficial in standardizing the assessment, prevention and treatment of pain, anxiety and delirium. While these practices show promise in addressing current management challenges in pediatric trauma, more research on how to better inform these practices in the pediatric trauma population is needed.