Iowa Health Book: Pediatrics
Pediatric Nursing Division, The University of Iowa Hospitals and Clinics
Patient Controlled Analgesia (PCA)
There are many ways to give pain medications. Pain medications can be given by mouth (orally), as a shot (intramuscularly, IM), or through an intravenous (IV) tube in a vein. Research has shown that children tend to be more honest about the pain they are having when they know that a complaint of pain will not result in a shot. At the University of Iowa Hospitals and Clinics, we try to avoid the IM method and use the IV or oral route for the administration of pain medications. One form of IV we can use is Patient Controlled Analgesia (PCA). PCA is a safe and effective way 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 line. There is a small amount of medication running constantly (basal rate). Also, when your child or you know that pain is present or increasing, your child or you can push the button attached to the PCA pump so an extra dose of medication is released into the IV.
How Often Should Your Child Push the Button?
Whenever your child has pain! A small amount of medication is immediately released to relieve the pain. The machine is set to limit the maximum amount of medication you can get as ordered by your doctor. It is helpful to push the PCA button for an extra dose of medication before your child needs to walk, do breathing exercises, or other activities.
Is There Any Danger of Taking an Overdose?
NO! The PCA system gives your child only the amount of medication prescribed by your doctor. The total number of doses the pump will allow your child to have is within a safe limit. If your child pushes the button more often than the amount prescribed by the doctor, medication will not be released. If your child's pain is not being relieved, inform your nurse so the doctor can make changes in the dose.
The PCA pump has many safety features and an alarm system. If your child drops the button or rolls over on it, the PCA pump will not release a dose of medication.
What Are the Benefits of Using PCA?
The PCA system lets you and your child control your child's pain. Your child will also be more alert with a constant flow of pain medication. As with any medications, your child may feel some side effects. A small number of people who receive morphine report feeling nausea, itching, or have trouble passing urine or stool. If any of these symptoms occur, you should notify your nurse or doctor.
We think you and your child will like using Patient Controlled Analgesia. Children as young as three years old have successfully used PCA. Parents can also assist the young child on PCA by pushing the button for the child. Your doctors and nurses will begin to take your child off the PCA pump when your child is able to take oral pain medications.
If you have any questions or concerns about PCA, please feel free to ask your doctor or nurse.
Pediatric Nursing Division
The University of Iowa Hospitals and Clinics
200 Hawkins Drive
Iowa City, Iowa 52242-1009