Children injection pain

Varicella vaccine (Varivax. Merck) is derived from live virus from u child with natural varicella. The virus has been attenuated by pos.sage through a series of guinea pig and human cell cultures. The final preparation is a lyophilized live, attenuated virus. The antigen form is whole virus. The antigen type is protein. The vaccine is well tolerated, with pain and redness at the injection site as the only. side effects. The vaccine has shown tremendous suece.ss in reducing infections. Indications arc... 

The varicella vaeeine ean eause a fever spike to 102°F, a mild rash with a few lesions, and pain and redness at the injection site. The nurse should tell the parents how to care for the child. 

Administration usually creates pain, anxiety and phobia, and requires professionally trained staff. Topical anaesthesia (creams, gels, patches or simply cold to numb the area) is usually performed to help to manage the pain and associated fears, as well as to distract the child. There is no taste issue with the parenteral routes but the excipients used must be biodegradable imder the available metabolic processes. This can be a problem in neonates as not all pathways have fully matured. Moreover, formulation composition is critical as some excipients can be toxic. This includes vehicles, preservatives or even the antiseptic used to disinfect the surface of the skin prior to injection (e.g. iodine-containing antiseptic that can be absorbed through the skin). 

The skin is prepared and draped in a sterile fashion, and local anesthesia is injected into the skin and deep soft tissues at the entry site using a 30-gauge needle in the anticipated route. One percent lidocaine mixed with sodium bicarbonate (3 cc 2 cc) minimizes discomfort. Inadequate local anesthesia will result in pain that will awaken the child and make the procedure more difficult and time-consuming. A skin incision is then made with a no. 11 scalpel blade and enlarged with blunt dissection. 

Dicobalt edentate Binding of cyanide ions by dicobalt edetate and by free cyanide ions Intravenous injection Adults 300 mg (20 mL of 15 mg/mL (15 %) Child 4-7.5 mg/kg (0.3-0.5 mL/kg of 15 mg/mL (15 %) 50 mL Dextrose (500 g/L) IV immediately after each dose and oxygen 1 min Urticaria, oedema of face and neck, chest pains, dyspnoea, hypotension, convulsions... 

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