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User can click on icon to access the healthcare worker resources page.",{"edges":549},[550,553,556,558,561,564,567,570,573,575,578,581,584,587,589,591,593,595,597,600,603,606,609,611,613,615,618,620,623,626,628,630,632,635,638,640,643,646,648,650,653,656,659,662,665,667,669,671],{"node":551},{"name":552},"Procedural Anxiety and Fear",{"node":554},{"name":555},"Measles",{"node":557},{"name":172},{"node":559},{"name":560},"Agitation",{"node":562},{"name":563},"Anxiety",{"node":565},{"name":566},"Iron Deficiency Anemia",{"node":568},{"name":569},"Influenza",{"node":571},{"name":572},"Advanced Life Support",{"node":574},{"name":53},{"node":576},{"name":577},"Migraine",{"node":579},{"name":580},"Abdominal Pain",{"node":582},{"name":583},"Pneumonia (Community Acquired)",{"node":585},{"name":586},"Chronic Pain",{"node":588},{"name":61},{"node":590},{"name":69},{"node":592},{"name":76},{"node":594},{"name":83},{"node":596},{"name":90},{"node":598},{"name":599},"COVID-19",{"node":601},{"name":602},"Cannabis",{"node":604},{"name":605},"Developmental and Intellectual Disabilities",{"node":607},{"name":608},"Child Abuse",{"node":610},{"name":97},{"node":612},{"name":104},{"node":614},{"name":111},{"node":616},{"name":617},"Critically Ill Neonate",{"node":619},{"name":119},{"node":621},{"name":622},"Eating Disorders",{"node":624},{"name":625},"Febrile Seizures",{"node":627},{"name":126},{"node":629},{"name":133},{"node":631},{"name":141},{"node":633},{"name":634},"Hand Foot and Mouth",{"node":636},{"name":637},"High Flow Nasal Cannula",{"node":639},{"name":148},{"node":641},{"name":642},"Meningitis",{"node":644},{"name":645},"Mental Health Self Assessment Tool",{"node":647},{"name":156},{"node":649},{"name":164},{"node":651},{"name":652},"Procedural Pain",{"node":654},{"name":655},"Procedural Sedation",{"node":657},{"name":658},"Sepsis",{"node":660},{"name":661},"Severe Head Injury",{"node":663},{"name":664},"Sickle Cell Disease",{"node":666},{"name":180},{"node":668},{"name":188},{"node":670},{"name":196},{"node":672},{"name":673},"Visiting the Emergency Department",{"debug":675,"queryAnalyzer":676},[],{"keys":677,"keysLength":678,"keysCount":679,"skippedKeys":680,"skippedKeysSize":681,"skippedKeysCount":681,"skippedTypes":682},"6d6b3d1b2eca580f2aae3985d71dc00ef8fba31240f69e3257cf81d43dbf639a graphql:Query list:menuitem list:audience list:topic cG9zdDoxODY4 cG9zdDo0ODU5 cG9zdDoxNjQ= cG9zdDo5NDc= cG9zdDoxNjA= cG9zdDo0NzAz cG9zdDoxNjE= cG9zdDoxNjM= cG9zdDoyMDE= cG9zdDoyMDI= cG9zdDoyMDM= cG9zdDoyMDU= cG9zdDoyMDY= cG9zdDoyMDg= cG9zdDoyNzkx cG9zdDoyMDk= cG9zdDoyMTA= cG9zdDoyNzky cG9zdDoyMTE= cG9zdDoyNzk2 cG9zdDoyNzkz cG9zdDo0NzA0 cG9zdDoyNzk3 cG9zdDoyNzk0 cG9zdDoyNzk1 cG9zdDoxOTE= cG9zdDoxOTI= cG9zdDoxOTY= cG9zdDoxOTU= cG9zdDoxOTQ= cG9zdDoxOTM= cG9zdDoxMjY= cG9zdDoxMjU= cG9zdDoxOTc= cG9zdDoxOTg= cG9zdDoxOTk= cG9zdDoyMDA= dGVybToxMDg= dGVybToyMA== dGVybTo0ODE= dGVybTo0NzY= dGVybTo0Njk= dGVybTo0NDc= dGVybTo0NTQ= dGVybTo0NTg= dGVybTo0NjE= dGVybTo0NjM= dGVybTo0NjQ= dGVybTo0NzE= dGVybTo0NzI= dGVybTo0MzI= dGVybTo0MzQ= dGVybToyMg== dGVybToyNQ== dGVybToyNw== dGVybToyOA== dGVybTozMA== dGVybTozNQ== dGVybTozMQ== dGVybTozMg== dGVybTo1OQ== dGVybTozMw== dGVybTozNA== dGVybTozNw== dGVybTozNg== dGVybTozOA== dGVybTo0MjE= dGVybToxMTQ= dGVybTo0MA== dGVybTo0MQ== dGVybTo0Mg== dGVybTo2MQ== dGVybToxMTA= dGVybTo0NA== dGVybTo0Ng== dGVybToxMDU= dGVybTo0Nw== dGVybTo0OA== dGVybTo1MQ== dGVybTo1Mg== dGVybTo1NA== dGVybTo1NQ== dGVybTo1Ng== dGVybTo1Nw== dGVybTo1OA== dGVybTo2MA== dGVybToxMDM= cG9zdDoyMzc3 cG9zdDoyMzc1",1274,94,"",0,[],{"data":684,"extensions":1051},{"topics":685},{"edges":686},[687,696,702,709,717,725,733,739,745,751,759,765,773,778,786,794,802,810,818,825,833,841,849,857,865,873,881,889,897,905,913,921,928,936,943,951,959,967,974,981,989,997,1005,1013,1021,1028,1035,1043],{"cursor":688,"node":689},"YXJyYXljb25uZWN0aW9uOjQ4MQ==",{"name":552,"slug":690,"description":691,"translations":692},"procedural-fear-and-anxiety","Anxiety and fears about medical procedures are common in children/youth: two-thirds report needle fear and 10% report needle phobia. Addressing this anxiety/fear is critical, as up to half of children seen in the Emergency Department undergo painful procedures (e.g., IVs, blood tests, catheterizations, wound repair). Procedural pain is complex, involving both physical pain and anxiety/fear. Inadequate management of either increases future anxiety and can lead to healthcare avoidance that persists into adulthood. Managing both improves procedural success and optimizes future care. ",[693],{"languageCode":694,"slug":695},"fr","peur-et-anxiete-procedurale",{"cursor":697,"node":698},"YXJyYXljb25uZWN0aW9uOjQ3Ng==",{"name":555,"slug":699,"description":700,"translations":701},"measles","Measles is a single stranded, enveloped RNA virus belonging to the Morbillivirus genus in the Paramyxoviridae family. The virus can cause a measles infection which starts in the respiratory epithelium of the nasopharynx. Measles is highly contagious.\r\n\r\nMore information coming soon. ",[],{"cursor":703,"node":704},"YXJyYXljb25uZWN0aW9uOjQ2OQ==",{"name":172,"slug":705,"description":171,"translations":706},"respiratory-distress",[707],{"languageCode":694,"slug":708},"detresse-respiratoire-fr",{"cursor":710,"node":711},"YXJyYXljb25uZWN0aW9uOjQ0Nw==",{"name":560,"slug":712,"description":713,"translations":714},"agitation","A clinical tool to guide decision-making when caring for agitated pediatric patients in emergency settings.",[715],{"languageCode":694,"slug":716},"prise-en-charge-du-patient-agite",{"cursor":718,"node":719},"YXJyYXljb25uZWN0aW9uOjQ1NA==",{"name":563,"slug":720,"description":721,"translations":722},"anxiety","Anxiety is a normal emotional and physiological response to uncomfortable, novel or frightening situations. During an emergency department (ED) visit, anxiety can be experienced by any child or adolescent as well as by their caregivers. It may be the primary reason for the visit or develop during assessments, procedures, or investigations. \r\nHow individuals experience anxiety during an ED visit can vary. Approaches to recognize, assess and manage anxiety need to be patient- and family-centred.\r\n",[723],{"languageCode":694,"slug":724},"anxiete",{"cursor":726,"node":727},"YXJyYXljb25uZWN0aW9uOjQ1OA==",{"name":566,"slug":728,"description":729,"translations":730},"iron-deficiency-anemia","Iron deficiency anemia (IDA) is most commonly found in toddlers and adolescents. A primary diagnosis should be identified to explain insufficient intake or excessive loss of iron. The treatment for IDA is supplemental iron. Blood transfusion is restricted to emergency management of patients with hemodynamic instability. ",[731],{"languageCode":694,"slug":732},"iron-deficiency-anemia-fr",{"cursor":734,"node":735},"YXJyYXljb25uZWN0aW9uOjQ2MQ==",{"name":569,"slug":736,"description":737,"translations":738},"influenza","Resources to support informed decision-making in the care of pediatric patients with influenza in emergency settings.",[],{"cursor":740,"node":741},"YXJyYXljb25uZWN0aW9uOjQ2Mw==",{"name":572,"slug":742,"description":743,"translations":744},"advanced-life-support","Pediatric Advanced Life Support (PALS) is a set of clinical guidelines and techniques used to provide emergency care to infants and children experiencing life-threatening medical conditions, such as cardiac arrest, respiratory failure, or shock. It focuses on rapid assessment, early intervention, and the use of advanced airway management, medications, and defibrillation to stabilize and resuscitate pediatric patients. ",[],{"cursor":746,"node":747},"YXJyYXljb25uZWN0aW9uOjQ2NA==",{"name":53,"slug":748,"description":749,"translations":750},"education-session","The tool provides access to all the  TREKK and University of Manitoba's virtual education session videos.",[],{"cursor":752,"node":753},"YXJyYXljb25uZWN0aW9uOjQ3MQ==",{"name":577,"slug":754,"description":755,"translations":756},"migraine","Migraine accounts for up to 30% of pediatric Emergency Department (ED) visits for headache and results in frequent ED revisits. The average age of onset is 7 years in boys and 9 years in girls. Migraine is more common in girls by adolescence. Evidence for ED management of acute migraine attacks in children and adolescents is limited, resulting in significant practice variation.",[757],{"languageCode":694,"slug":758},"migraine-fr",{"cursor":760,"node":761},"YXJyYXljb25uZWN0aW9uOjQ3Mg==",{"name":580,"slug":762,"description":763,"translations":764},"abdominal-pain","Abdominal pain is a common complaint in children, often leading to visits to the emergency department (ED). It can be caused by various conditions, ranging from mild issues like constipation or gas to more serious concerns such as infections or gastrointestinal conditions. Children may experience abdominal pain differently, with younger children having difficulty describing their discomfort. Recognizing, assessing, and managing abdominal pain requires a patient- and family-centred approach to address both the physical and emotional aspects of care.",[],{"cursor":766,"node":767},"YXJyYXljb25uZWN0aW9uOjQzMg==",{"name":583,"slug":768,"description":769,"translations":770},"pneumonia","Viruses are the leading cause of pneumonia in healthy young children, followed by bacteria and rarely, other organisms. These resources focus on uncomplicated community acquired pneumonia (CAP).",[771],{"languageCode":694,"slug":772},"pneumonie",{"cursor":774,"node":775},"YXJyYXljb25uZWN0aW9uOjQzNA==",{"name":586,"slug":776,"description":14,"translations":777},"chronic-pain",[],{"cursor":779,"node":780},"YXJyYXljb25uZWN0aW9uOjIy",{"name":61,"slug":781,"description":782,"translations":783},"aom","Acute Otitis Media (AOM) is common in children under 5 years of age and is often a self-limited illness lasting several days. The mainstay of AOM management is symptom/pain control. In some cases, AOM can be more prolonged or severe and requires antibiotic treatment.",[784],{"languageCode":694,"slug":785},"aom-fr",{"cursor":787,"node":788},"YXJyYXljb25uZWN0aW9uOjI1",{"name":69,"slug":789,"description":790,"translations":791},"anaphylaxis","Anaphylaxis is a serious systemic hypersensitivity reaction that is rapid in onset and can be fatal. The highest incidence of anaphylaxis is in children and youth. The three principal triggers of anaphylaxis are foods, insect stings, and drugs. In Canada, there is an Emergency Department (ED) visit for food allergy approximately every 10 minutes, and up to 80% of anaphylactic reactions in children are triggered by foods such as peanuts, tree nuts, and milk.",[792],{"languageCode":694,"slug":793},"anaphylaxis-fr",{"cursor":795,"node":796},"YXJyYXljb25uZWN0aW9uOjI3",{"name":76,"slug":797,"description":798,"translations":799},"asthma","Approximately one-third of children with asthma presenting to the emergency department (ED) have moderate respiratory distress, and less than 5% will have a severe exacerbation. There are some differences between provincial asthma pathways with regards to PRAM scores and treatment. ",[800],{"languageCode":694,"slug":801},"asthme",{"cursor":803,"node":804},"YXJyYXljb25uZWN0aW9uOjI4",{"name":83,"slug":805,"description":806,"translations":807},"bronchiolitis","Bronchiolitis is a common viral illness. It is most commonly caused by respiratory syncytial virus and typically occurs over the late fall and winter months. Children less than 2 years of age are most commonly affected, with the largest burden of illness being in children less than 12 months of age.",[808],{"languageCode":694,"slug":809},"bronchiolitis-fr",{"cursor":811,"node":812},"YXJyYXljb25uZWN0aW9uOjMw",{"name":90,"slug":813,"description":814,"translations":815},"burns","Burns are a leading cause of unintentional injury and death in children, with the vast majority of cases occurring in the home. Regardless of the burn depth or extent, these injuries can have significant long-term functional, aesthetic, and psychological consequences for the child.",[816],{"languageCode":694,"slug":817},"burns-fr",{"cursor":819,"node":820},"YXJyYXljb25uZWN0aW9uOjM1",{"name":599,"slug":821,"description":14,"translations":822},"covid-19",[823],{"languageCode":694,"slug":824},"covid-19-fr",{"cursor":826,"node":827},"YXJyYXljb25uZWN0aW9uOjMx",{"name":602,"slug":828,"description":829,"translations":830},"cannabis-intoxication","Cannabis contains two well known components, Delta-9 Tetrahydrocannabinol (Δ-9-THC) and Cannabidiol (CBD). The psychoactive properties of cannabis are typically attributed to Δ-9-THC, which is present in variable concentrations dependent on the strain, and absorbed at variable rates dependent on the mode of ingestion. Acute intoxication is rare from cannabidiol (CBD) products unless given in excess or with high THC:CBD ratio. Since Canadian legalization of cannabis for adults, there has been an increasing rate of hospitalization for cannabis exposures in children 14 years and younger.",[831],{"languageCode":694,"slug":832},"cannabis-intoxication-fr",{"cursor":834,"node":835},"YXJyYXljb25uZWN0aW9uOjMy",{"name":605,"slug":836,"description":837,"translations":838},"developmental-and-intellectual-disabilities","Children and youth with developmental or intellectual delays/disorders (DD) use Emergency Department (ED) 1.8 times more frequently than the general pediatric population. This population of patients includes those with autism spectrum disorder (ASD), fetal alcohol spectrum disorder (FASD), or other conditions. This document provides recommendations for the medical approach to these patients to assist in optimizing care.",[839],{"languageCode":694,"slug":840},"caring-for-children-with-developmental-and-intellectual-disabilities-fr",{"cursor":842,"node":843},"YXJyYXljb25uZWN0aW9uOjU5",{"name":608,"slug":844,"description":845,"translations":846},"child-abuse","Children under 3 years of age are at highest risk for serious injuries from abuse. Being alert to findings that suggest abuse will improve early recognition and prevent recurrent, escalating abuse. The extent of the workup performed in the emergency department will vary based on geography, acuity of injury, and services available. Early consultation with a Pediatric Referral Centre or child protection team is recommended.",[847],{"languageCode":694,"slug":848},"child-abuse-fr",{"cursor":850,"node":851},"YXJyYXljb25uZWN0aW9uOjMz",{"name":97,"slug":852,"description":853,"translations":854},"concussion","Concussion is a traumatic brain injury resulting from acceleration/deceleration forces from a direct blow to the head, face, neck or elsewhere on the body with an 'impulsive' force transmitted to the head. Loss of consciousness and amnesia are not required to make the diagnosis.",[855],{"languageCode":694,"slug":856},"concussion-fr",{"cursor":858,"node":859},"YXJyYXljb25uZWN0aW9uOjM0",{"name":104,"slug":860,"description":861,"translations":862},"constipation","Children with functional constipation (FC) often present to the ED with impaction or colicky abdominal pain. The prevalence of FC in infants and toddlers is approximately 20%. While organic causes are responsible for less than 5% of constipation in children, FC may mimic surgical causes of abdominal pain, such as appendicitis, intussusception and bowel obstruction, thus a careful assessment is required before making this diagnosis.",[863],{"languageCode":694,"slug":864},"constipation-fr",{"cursor":866,"node":867},"YXJyYXljb25uZWN0aW9uOjM3",{"name":111,"slug":868,"description":869,"translations":870},"croup","Croup is the most common cause of upper airway obstruction in children. It is characterized by acute onset of barky cough +/- stridor. The typical age of presentation is between 6 months and 5 years with a peak around 2 years. Consider other causes of upper airway obstruction such as bacterial tracheitis, epiglottitis and retropharyngeal abscess in children presenting with severe symptoms and a transient or lack of response to croup treatment.",[871],{"languageCode":694,"slug":872},"croup-fr",{"cursor":874,"node":875},"YXJyYXljb25uZWN0aW9uOjM2",{"name":617,"slug":876,"description":877,"translations":878},"critically-ill-neonate","A clinical tool to guide decision-making when caring for critically ill pediatric patients in emergency settings. \r\nUse in infants 0-28 days. At birth, refer to NRP guidelines. Not intended for preterm infants less than 37 weeks",[879],{"languageCode":694,"slug":880},"critically-ill-neonate-fr",{"cursor":882,"node":883},"YXJyYXljb25uZWN0aW9uOjM4",{"name":119,"slug":884,"description":885,"translations":886},"dka","Diabetic ketoacidosis is a complication of new or existing pediatric diabetes and may be complicated by cerebral injury. Due to this risk, it is treated differently than adult DKA. Health care providers must follow a published pediatric-specific protocol when treating pediatric DKA. Early communication with the diabetes specialist at your pediatric referral site is a key element of the management of these patients. \r\n\r\nKey highlights include dehydration is a key component of DKA pathophysiology; all patients with DKA should receive a 20 ml/kg IV bolus of normal saline or Ringer's lactate over 20 minutes at the initiation of treatment, which can be repeated if the patient remains hypoperfused; ongoing fluids in DKA should be weight-based and account for the significant fluid deficit, with an increased maximum of 500 ml/hr; and every patient in DKA is at risk of cerebral injury before and during treatment, especially if DKA is more severe. Assess every patient with DKA for signs of cerebral injury and follow the TREKK DKA algorithm. \r\n\r\nIn June 2023, TREKK’s DKA resources have been updated to reflect the 2022 International Society for Pediatric and Adolescent Diabetes (ISPAD) guidelines.",[887],{"languageCode":694,"slug":888},"dka-fr",{"cursor":890,"node":891},"YXJyYXljb25uZWN0aW9uOjQyMQ==",{"name":622,"slug":892,"description":893,"translations":894},"eating-disorders","Eating disorders are complex biopsychosocial disorders with significant medical sequelae and a high mortality rate. They exist across diverse populations regardless of age, race, ethnicity, gender, sexual orientation, body habitus, and socioeconomic background. Over the past several years, eating disorder diagnoses have increased globally.",[895],{"languageCode":694,"slug":896},"troubles-alimentaires",{"cursor":898,"node":899},"YXJyYXljb25uZWN0aW9uOjExNA==",{"name":625,"slug":900,"description":901,"translations":902},"febrile-seizures","A febrile seizure is a convulsion accompanied by a fever or illness. The child usually has muscle twitching, jerking or stiffness for a few minutes. The child usually loses consciousness and it is common for the child’s eyes to roll upward. Most children are sleepy afterward and are not responsive to your voice.\r\n\r\nFebrile seizures are common. Between 2-5% of children will have at least one febrile seizure when they are between 6 months and 5 years old. This video will help you to understand what is happening to your child and will help prepare you for your medical visit.",[903],{"languageCode":694,"slug":904},"febrile-seizures-fr",{"cursor":906,"node":907},"YXJyYXljb25uZWN0aW9uOjQw",{"name":126,"slug":908,"description":909,"translations":910},"fever","Neonates (less than or equal to 28 days of age) and young infants (29-60 days of age) with fever account for a significant number of emergency department (ED) visits. At this age, there is an increased risk of urinary tract infections and invasive bacterial infections (IBIs), specifically bacteremia and bacterial meningitis. Most febrile young infants have self-limited viral illnesses, however up to 2-3% harbour life-threatening IBIs. Clinical examination can be unreliable in determining the source or severity of infection. The difficulty lies in differentiating the infant with IBIs from those without, while minimizing the risks of over-investigations. Additionally, infants with IBIs are at risk of poor outcomes if not diagnosed and treated promptly.",[911],{"languageCode":694,"slug":912},"fever-fr",{"cursor":914,"node":915},"YXJyYXljb25uZWN0aW9uOjQx",{"name":133,"slug":916,"description":917,"translations":918},"fractures","Children break bones more easily than adults - so pediatric fractures are very common. There are several unique features of the pediatric musculoskeletal system that need to be considered in management decisions of all of these injuries - growth plates, plasticity, callus formation, remodeling potential, and partial breaks are some of the key ones. Recognition and appropriate management of pediatric fractures by ED providers is critical. While some common minor wrist and ankle fractures can be treated with a less conservative approach encouraging an early return to activities, other fractures if not treated properly can result in long term functional problems for the child and/or be a sign of child maltreatment.",[919],{"languageCode":694,"slug":920},"fractures-fr",{"cursor":922,"node":923},"YXJyYXljb25uZWN0aW9uOjQy",{"name":141,"slug":924,"description":140,"translations":925},"gastroenteritis",[926],{"languageCode":694,"slug":927},"gastroenteritis-fr",{"cursor":929,"node":930},"YXJyYXljb25uZWN0aW9uOjYx",{"name":634,"slug":931,"description":932,"translations":933},"hand-foot-mouth","Hand-foot-mouth disease or coxsackie is a common viral illness that most children get at some point that can cause symptoms including fever, rash, spots in the mouth and decreased feeding. This short video will help you to understand what to expect when your child has coxsackie and how you can care for them.",[934],{"languageCode":694,"slug":935},"hand-foot-mouth-fr",{"cursor":937,"node":938},"YXJyYXljb25uZWN0aW9uOjExMA==",{"name":637,"slug":939,"description":14,"translations":940},"high-flow-nasal-cannula",[941],{"languageCode":694,"slug":942},"high-flow-nasal-cannula-fr",{"cursor":944,"node":945},"YXJyYXljb25uZWN0aW9uOjQ0",{"name":148,"slug":946,"description":947,"translations":948},"intussusception","Intussusception is invagination of the intestine into an adjacent segment, most commonly involving the ileocecal valve. This process occludes blood supply to the bowel and can progress from tissue ischemia to necrosis/perforation. It is most likely to be idiopathic, but can be caused by a variety of pathological lead points.",[949],{"languageCode":694,"slug":950},"intussusception-fr",{"cursor":952,"node":953},"YXJyYXljb25uZWN0aW9uOjQ2",{"name":642,"slug":954,"description":955,"translations":956},"meningitis","Most cases of childhood meningitis are caused by an enterovirus. Bacterial meningitis is less common, with 90% of cases occurring in children less than 5 years of age. Bacterial meningitis has a mortality rate of 20% in infants and 2% in children; neurologic sequalae occur in approximately one-third of children who survive their infection. Early diagnosis and treatment of bacterial meningitis is associated with better outcomes. Viral meningitis is a diagnosis of exclusion.",[957],{"languageCode":694,"slug":958},"meningitis-fr",{"cursor":960,"node":961},"YXJyYXljb25uZWN0aW9uOjEwNQ==",{"name":645,"slug":962,"description":963,"translations":964},"mental-health-self-assessment-tool","On this page, you will find evidence-based tools and information surrounding pediatric mental health concerns. The information provided on TREKK.ca is designed to complement, not replace, the relationship between a patient and their own physician or healthcare provider.",[965],{"languageCode":694,"slug":966},"mental-health-self-assessment-tool-fr",{"cursor":968,"node":969},"YXJyYXljb25uZWN0aW9uOjQ3",{"name":156,"slug":970,"description":155,"translations":971},"multisystem-trauma",[972],{"languageCode":694,"slug":973},"multisystem-trauma-fr",{"cursor":975,"node":976},"YXJyYXljb25uZWN0aW9uOjQ4",{"name":164,"slug":977,"description":163,"translations":978},"pain-treatment",[979],{"languageCode":694,"slug":980},"pain-treatment-fr",{"cursor":982,"node":983},"YXJyYXljb25uZWN0aW9uOjUx",{"name":652,"slug":984,"description":985,"translations":986},"procedural-pain","Common medical procedures used to assess and treat children can cause significant pain and distress. Untreated pain has short-term (pain and distress for the child, caregivers, and healthcare providers; prolonged procedure time; slower healing) and long-term consequences (increased sensitivity to pain; avoidance of healthcare settings; needle phobia, higher levels of anxiety before a procedure). Timely and effective multi-modal pain care improves procedure success rates, prevents the need for repeated attempts, improves patient flow, and improves patient and caregiver satisfaction. Before initiating any procedure: consider whether it is truly necessary, batch procedures together, optimize pain management, and engage caregivers in planning/decision-making. ",[987],{"languageCode":694,"slug":988},"procedural-pain-fr",{"cursor":990,"node":991},"YXJyYXljb25uZWN0aW9uOjUy",{"name":655,"slug":992,"description":993,"translations":994},"procedural-sedation","A brief summary of current knowledge needed to perform safe and effective procedural sedation in children.",[995],{"languageCode":694,"slug":996},"procedural-sedation-fr",{"cursor":998,"node":999},"YXJyYXljb25uZWN0aW9uOjU0",{"name":658,"slug":1000,"description":1001,"translations":1002},"sepsis","Sepsis is a systemic response to infection; it is a leading cause of morbidity and mortality worldwide. Early recognition, aggressive resuscitation (fluids, metabolic correction, antibiotics) and escalation of care (vasoactive medications) are key to improving patient outcomes.",[1003],{"languageCode":694,"slug":1004},"sepsis-fr",{"cursor":1006,"node":1007},"YXJyYXljb25uZWN0aW9uOjU1",{"name":661,"slug":1008,"description":1009,"translations":1010},"severe-head-injury","Head trauma is considered severe in a child with a Glasgow Coma Scale (GCS) score of ≤ 8. These children often have intracranial injury identified on neuroimaging and all have suffered traumatic brain injury (TBI). Injury is the leading cause of death in children >1 year of age, and TBI is the most significant cause of death and disability across all ages.",[1011],{"languageCode":694,"slug":1012},"severe-head-injury-fr",{"cursor":1014,"node":1015},"YXJyYXljb25uZWN0aW9uOjU2",{"name":664,"slug":1016,"description":1017,"translations":1018},"scd","Sickle cell disease (SCD) is a genetic disorder of hemoglobin, in which sickling of red blood cells results in hemolysis and vasoocclusion. Newborn screening has led to early identification of SCD in many regions across Canada. While homozygous SCD (HbSS) is the most severe, other sickling syndromes (e.g., HbSC) may present similarly.",[1019],{"languageCode":694,"slug":1020},"scd-fr",{"cursor":1022,"node":1023},"YXJyYXljb25uZWN0aW9uOjU3",{"name":180,"slug":1024,"description":179,"translations":1025},"status-epilepticus",[1026],{"languageCode":694,"slug":1027},"status-epilepticus-fr",{"cursor":1029,"node":1030},"YXJyYXljb25uZWN0aW9uOjU4",{"name":188,"slug":1031,"description":187,"translations":1032},"suicidal-risk-screening-assessment",[1033],{"languageCode":694,"slug":1034},"suicidal-risk-screening-assessment-fr",{"cursor":1036,"node":1037},"YXJyYXljb25uZWN0aW9uOjYw",{"name":196,"slug":1038,"description":1039,"translations":1040},"uti","UTI is among the most common serious bacterial infections seen in infants and children. UTI with fever is indicative of an upper tract infection/pyelonephritis, as opposed to afebrile cystitis. It is important to diagnose and empirically treat febrile UTIs in infants and children, as delayed treatment may increase the risk of bacteremia. There are a number of risk factors associated with increased rates of UTI in young children such as age, gender and height of fever. ",[1041],{"languageCode":694,"slug":1042},"uti-fr",{"cursor":1044,"node":1045},"YXJyYXljb25uZWN0aW9uOjEwMw==",{"name":673,"slug":1046,"description":1047,"translations":1048},"visiting-ed","The Emergency Department (ED) is a place where people go for immediate care.\r\nVisiting the ED can be scary and overwhelming, especially when you don’t know what to expect. We hope these resources helps reduce stress and helps you prepare.\r\n",[1049],{"languageCode":694,"slug":1050},"visiting-ed-fr",{"debug":1052,"queryAnalyzer":1053},[],{"keys":1054,"keysLength":1055,"keysCount":1056,"skippedKeys":680,"skippedKeysSize":681,"skippedKeysCount":681,"skippedTypes":1057},"9ba504182e5375d8ee802ccd07f58575ad4f11b79a3c746ac62c55429115da0f graphql:Query list:topic dGVybTo0ODE= dGVybTo0NzY= dGVybTo0Njk= dGVybTo0NDc= dGVybTo0NTQ= dGVybTo0NTg= dGVybTo0NjE= dGVybTo0NjM= dGVybTo0NjQ= dGVybTo0NzE= dGVybTo0NzI= dGVybTo0MzI= dGVybTo0MzQ= dGVybToyMg== dGVybToyNQ== dGVybToyNw== dGVybToyOA== dGVybTozMA== dGVybTozNQ== dGVybTozMQ== dGVybTozMg== dGVybTo1OQ== dGVybTozMw== dGVybTozNA== dGVybTozNw== dGVybTozNg== dGVybTozOA== dGVybTo0MjE= dGVybToxMTQ= dGVybTo0MA== dGVybTo0MQ== dGVybTo0Mg== dGVybTo2MQ== dGVybToxMTA= dGVybTo0NA== dGVybTo0Ng== dGVybToxMDU= dGVybTo0Nw== dGVybTo0OA== dGVybTo1MQ== dGVybTo1Mg== dGVybTo1NA== dGVybTo1NQ== dGVybTo1Ng== dGVybTo1Nw== dGVybTo1OA== dGVybTo2MA== dGVybToxMDM=",713,51,[],{"data":1059,"extensions":1153},{"footer_1":1060,"footer_2":1078,"footer_3":1105,"footer_privacy":1118,"social":1125,"footer":1139},{"edges":1061},[1062,1067,1072],{"cursor":1063,"node":1064},"YXJyYXljb25uZWN0aW9uOjE2Ng==",{"label":29,"uri":31,"target":14,"menu":1065},{"node":1066},{"name":12},{"cursor":1068,"node":1069},"YXJyYXljb25uZWN0aW9uOjIwMzg=",{"label":36,"uri":38,"target":14,"menu":1070},{"node":1071},{"name":12},{"cursor":1073,"node":1074},"YXJyYXljb25uZWN0aW9uOjE2OA==",{"label":1075,"uri":13,"target":14,"menu":1076},"All Topics",{"node":1077},{"name":12},{"edges":1079},[1080,1085,1090,1095,1100],{"cursor":1081,"node":1082},"YXJyYXljb25uZWN0aW9uOjE2OQ==",{"label":441,"uri":435,"target":14,"menu":1083},{"node":1084},{"name":448},{"cursor":1086,"node":1087},"YXJyYXljb25uZWN0aW9uOjE3MA==",{"label":448,"uri":481,"target":14,"menu":1088},{"node":1089},{"name":448},{"cursor":1091,"node":1092},"YXJyYXljb25uZWN0aW9uOjE3MQ==",{"label":455,"uri":487,"target":14,"menu":1093},{"node":1094},{"name":448},{"cursor":1096,"node":1097},"YXJyYXljb25uZWN0aW9uOjE3Mg==",{"label":462,"uri":493,"target":14,"menu":1098},{"node":1099},{"name":448},{"cursor":1101,"node":1102},"YXJyYXljb25uZWN0aW9uOjIxMjk=",{"label":469,"uri":499,"target":14,"menu":1103},{"node":1104},{"name":448},{"edges":1106},[1107,1113],{"cursor":1108,"node":1109},"YXJyYXljb25uZWN0aW9uOjE3NA==",{"label":506,"uri":507,"target":14,"menu":1110},{"node":1111},{"name":1112},"Info",{"cursor":1114,"node":1115},"YXJyYXljb25uZWN0aW9uOjE3Mw==",{"label":510,"uri":511,"target":14,"menu":1116},{"node":1117},{"name":1112},{"edges":1119},[1120],{"cursor":1121,"node":1122},"YXJyYXljb25uZWN0aW9uOjE3NQ==",{"label":1123,"uri":1124,"target":14},"Terms of Use","/terms-of-use/",{"edges":1126},[1127,1130,1133,1136],{"cursor":1128,"node":1129},"YXJyYXljb25uZWN0aW9uOjE5Nw==",{"label":516,"url":517,"target":14},{"cursor":1131,"node":1132},"YXJyYXljb25uZWN0aW9uOjE5OA==",{"label":520,"url":521,"target":14},{"cursor":1134,"node":1135},"YXJyYXljb25uZWN0aW9uOjE5OQ==",{"label":524,"url":525,"target":14},{"cursor":1137,"node":1138},"YXJyYXljb25uZWN0aW9uOjIwMA==",{"label":528,"url":529,"target":14},{"optionsTheme":1140},{"newsletterTitle":1141,"newsletterTitleFr":1142,"newsletterDescription":1143,"newsletterDescriptionFr":1144,"newsletterUrl":1145,"newsletterUrlFr":1149,"landAcknowledgement":1151,"landAcknowledgementFr":1152},"Subscribe to our Newsletter","Abonnez-vous à notre bulletin d'information","When you subscribe to this e-update, new issues will be sent to your email address the moment they are published.","Lorsque vous vous abonnez à cette mise à jour électronique, les nouveaux numéros seront envoyés à votre adresse e-mail dès leur publication.",{"title":1146,"url":1147,"target":1148},"Subscribe","https://trekk.us16.list-manage.com/subscribe?u=31840b6f27d1074425db8898a&id=2c90e9e1a9","_blank",{"title":1150,"url":1147,"target":1148},"S'inscrire","\u003Cp>TREKK acknowledges that our network is situated on the unceded and ancestral territories of diverse Indigenous Peoples across Turtle Island. \u003C/p>\n\u003Cp>From coast to coast to coast, we respect and acknowledge Inuit, Métis, and First Nations Peoples as the traditional stewards of the lands we work and live on. For those of us who are settlers, we recognize that processes of colonization continue to impact Indigenous Peoples today. TREKK is committed to working toward cultural safety, decolonization, and reconciliation.\u003C/p>\n","\u003Cp>TREKK reconnaît que notre réseau est situé sur les territoires non cédés et ancestraux de divers peuples autochtones de l'Île de la Tortue.\u003C/p>\n\u003Cp>D’un océan à l’autre, nous respectons et reconnaissons les Inuits, les Métis et les Premières Nations en tant que gardiens traditionnels des terres sur lesquelles nous travaillons et vivons. Pour ceux d’entre nous qui sont des colons, nous reconnaissons que les processus de colonisation continuent d’avoir un impact sur les peuples autochtones aujourd’hui. TREKK s’engage à œuvrer en faveur de la sécurité culturelle, de la décolonisation et de la réconciliation.\u003C/p>\n",{"debug":1154,"queryAnalyzer":1155},[],{"keys":1156,"keysLength":1157,"keysCount":1158,"skippedKeys":680,"skippedKeysSize":681,"skippedKeysCount":681,"skippedTypes":1159},"d9a1e4a4227d63ecc282d2b69b4b64d07ba73e19765e9d47f113fdada604cd45 graphql:Query list:menuitem cG9zdDoxNjY= cG9zdDoyMDM4 cG9zdDoxNjg= cG9zdDoxNjk= cG9zdDoxNzA= cG9zdDoxNzE= cG9zdDoxNzI= cG9zdDoyMTI5 cG9zdDoxNzQ= cG9zdDoxNzM= cG9zdDoxNzU= cG9zdDoxOTc= cG9zdDoxOTg= cG9zdDoxOTk= cG9zdDoyMDA= YWNmX29wdGlvbnNfcGFnZTp0aGVtZS1zZXR0aW5ncw== dGVybTo3Ng== dGVybTo3Nw== dGVybTo3OA==",371,22,[],{"data":1161,"extensions":1239},{"resource":1162},{"title":1163,"databaseId":1164,"excerpt":680,"uri":1165,"language":1166,"translations":1168,"ptResources":1191},"Evidence Repository:  Procedural Anxiety and Fear",4961,"/resources/evidence-repository-procedural-anxiety-and-fear/",{"code":1167},"en",[1169],{"slug":1170,"uri":1171,"title":1172,"languageCode":694,"ptResources":1173},"referentiel-medical-peur-et-anxiete-procedurale","/fr/resources/referentiel-medical-peur-et-anxiete-procedurale/","Référentiel médical: Peur et anxiété procédurale",{"mainTitle":1174,"subTitle":14,"media":1175,"pdf":1176,"link":14,"videos":14,"sections":1182},"Peur et anxiété procédurale","PDF",{"cursor":1177,"node":1178},"YXJyYXljb25uZWN0aW9uOjQ5NjY=",{"fileSize":1179,"mediaItemUrl":1180,"translations":1181},371102,"https://cms.trekk.ca/wp-content/uploads/2026/04/2026_04_14_Procedural-Anxiety-and-Fear_Evidence-Repository_v1.0-FR.pdf",[],[1183,1185,1186,1187,1188,1189,1190],{"__typename":1184},"PtResourcesSectionsContentLayout",{"__typename":1184},{"__typename":1184},{"__typename":1184},{"__typename":1184},{"__typename":1184},{"__typename":1184},{"publish":1192,"description":1193,"eyebrow":1194,"mainTitle":552,"subTitle":14,"lastUpdated":14,"developed":1195,"developedBy":1196,"developedByCopy":14,"underReview":1192,"englishOnlyFlag":1192,"multipleLanguages":1192,"mainImage":14,"media":1175,"pdf":1197,"link":14,"videos":14,"footnote":14,"sections":1202,"audience":1223,"topic":1228,"type":1233},false,"\u003Cp>A collection of the best available resources and evidence in Procedural Anxiety and Fear (clinical guidelines, peer-reviewed literature, systematic reviews, etc.), collated by our knowledge synthesis team and content advisors.\u003C/p>\n","Evidence Repository","2026-02-12T00:00:00+00:00","ARCHE, & TREKK",{"cursor":1198,"node":1199},"YXJyYXljb25uZWN0aW9uOjQ5NjI=",{"fileSize":1200,"mediaItemUrl":1201},396037,"https://cms.trekk.ca/wp-content/uploads/2026/04/2026_02_12_PROCEDURAL-ANXIETY_Evidence-Repository.pdf",[1203,1206,1209,1212,1215,1218,1220],{"__typename":1184,"title":1204,"subTitle":1192,"content":1205},"EVIDENCE REPOSITORIES","\u003Cp>This evidence repository is a collection of best available resources and evidence collated by a knowledge synthesis team at Alberta Research for Health Evidence (\u003Ca href=\"https://www.ualberta.ca/pediatrics/pediatric-research/affiliated-research-units/alberta-research-centre-for-health-evidence-arche/index.html\">ARCHE\u003C/a>) and the clinical content team.\u003C/p>\n\u003Cp>The knowledge synthesis team utilizes a pyramid-shaped framework, built upon the \u003Ca href=\"https://ebn.bmj.com/content/8/1/4\" target=\"_blank\" rel=\"noopener\">“4S” hierarchy of\u003C/a> \u003Ca href=\"https://ebn.bmj.com/content/8/1/4\" target=\"_blank\" rel=\"noopener\">evidence model\u003C/a>, to provide detailed evidence appropriate to meet stakeholders’ needs. They search a combination of databases (Cochrane Library, PubMed, TRIP Database) and web-based search engines (Google, Google Scholar) to locate evidence for the knowledge pyramids. Publication types sought in the initial topic searches are organized into five levels that determine the order in which resources are presented:\u003C/p>\n\u003Col>\n\u003Cli>Bottom Line Recommendations\u003C/li>\n\u003Cli>Clinical Practice Guidelines and Pathways\u003C/li>\n\u003Cli>Overviews and Summaries of Systematic Reviews\u003C/li>\n\u003Cli>Systematic Reviews\u003C/li>\n\u003Cli>Key Studies\u003C/li>\n\u003C/ol>\n\u003Cp>Where applicable resources for families and parents are also listed.\u003C/p>\n",{"__typename":1184,"title":1207,"subTitle":1192,"content":1208},"Key Studies","\u003Cp>The knowledge synthesis team collaborates with the clinical content team to select the most relevant guidelines, reviews, and key studies, which can be found below. This evidence repository is not intended to be an exhaustive list of resources for a topic, but rather a curated list of current, evidence-based resources, based on expert consensus of relevance and usability for a general emergency department setting. Every effort is made to identify resources that are open access (i.e. publicly available, free of charge, not requiring a subscription).\u003C/p>\n\u003Cp>More information about the creation of our evidence repositories can be found \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/28537762/\">here\u003C/a>.\u003C/p>\n",{"__typename":1184,"title":1210,"subTitle":1192,"content":1211},"Content Team","\u003Cp>Thank you to the following clinical content experts and Knowledge Synthesis team who led the development of this evidence repository.\u003C/p>\n\u003Cp>\u003Cstrong>Samina Ali, MD, FRCPC\u003C/strong> Professor, Department of Pediatrics and Adjunct Professor, Department of Emergency Medicine, \u003Cem>University of Alberta\u003C/em>\u003C/p>\n\u003Cp>\u003Cstrong>Naveen Poonai, MSC, MD, FRCPC\u003C/strong> \u003Cem>Professor, Pediatrics, Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry Scientist, Child Health Research Institute \u003C/em>\u003C/p>\n\u003Cp>\u003Cstrong>Kathryn Birnie, PhD RPsych\u003C/strong> \u003Cem>Associate Professor, Cumming School of Medicine, Department of Anesthesiology, Perioperative and Pain Management, and Department of Community Health Sciences, University of Calgary \u003C/em>\u003C/p>\n\u003Cp>\u003Cstrong>Samantha Guitard,\u003C/strong> \u003Cstrong>MSc\u003C/strong> \u003Cem>Evidence Synthesis Scientist, Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta \u003C/em>\u003C/p>\n\u003Cp>\u003Cstrong>Sarah Elliott\u003C/strong>, \u003Cstrong>PhD\u003C/strong> \u003Cem>Assistant Director, Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta\u003C/em>\u003C/p>\n\u003Cp>References in \u003Cstrong>bold\u003C/strong> correspond to those used in the Bottom Line Recommendations.\u003C/p>\n",{"__typename":1184,"title":1213,"subTitle":1192,"content":1214},"Clinical Practice Guidelines And Pathways","\u003Col>\n\u003Cli>\u003Cstrong>Trottier ED, Doré-Bergeron MJ, Chauvin-Kimoff L, Chauvin-Kimoff L, Baerg K, Ali S. \u003Ca href=\"https://cps.ca/en/documents/position/managing-pain-and-distress\">Managing pain and distress in children undergoing brief diagnostic and therapeutic procedures.\u003C/a> \u003Cem>Can Paediatr Soc.\u003C/em> Updated 2025.\u003C/strong>\u003C/li>\n\u003Cli>\u003Cstrong>Solutions for Kids in Pain (SKIP), Health Standards Organization (HSO). CAN/HSO \u003Ca href=\"https://healthstandards.org/standard/pediatric-pain-management-can-hso-13200-2023-e/\" target=\"_blank\" rel=\"noopener\">13200:2023 – Pediatric Pain Management\u003C/a>. Updated 2023.\u003C/strong>\u003C/li>\n\u003Cli>McMurtry CM, Taddio A, Noel M, et al. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/27007463/\" target=\"_blank\" rel=\"noopener\">Exposure-based interventions for the management of\u003C/a> \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/27007463/\" target=\"_blank\" rel=\"noopener\">individuals with high levels of needle fear across the lifespan: A clinical practice \u003C/a>\u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/26303247/\" target=\"_blank\" rel=\"noopener\">guideline\u003C/a>\u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/27007463/\" target=\"_blank\" rel=\"noopener\"> and call\u003C/a> \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/27007463/\" target=\"_blank\" rel=\"noopener\">for further research\u003C/a>. \u003Cem>Cogn Behav Ther.\u003C/em> 2016;45(3):217-35.\u003C/li>\n\u003Cli>Taddio A, McMurtry CM, Shah V, et al. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/26303247/\">Reducing pain during vaccine injections: Clinical practice guideline.\u003C/a> \u003Cem>CMAJ.\u003C/em> 2015;187(13):975-82.\u003C/li>\n\u003C/ol>\n",{"__typename":1184,"title":1216,"subTitle":1192,"content":1217},"Systematic Reviews And Other Reviews","\u003Col>\n\u003Cli>Wang L, Fang L, Zhou Y, et al. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/36780438/\" target=\"_blank\" rel=\"noopener\">Efficacy and safety of vapocoolant spray for vascular puncture in\u003C/a> \u003Ca href=\"https://www.nejm.org/doi/pdf/10.1056/NEJMvcm1411127?articleTools=true.\" target=\"_blank\" rel=\"noopener\">children\u003C/a>\u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/36780438/\" target=\"_blank\" rel=\"noopener\"> and adults: A \u003C/a>\u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/36523723/\" target=\"_blank\" rel=\"noopener\">systematic review and meta-\u003C/a>\u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/35943776/\" target=\"_blank\" rel=\"noopener\">analysis\u003C/a>. \u003Cem>PLoS One.\u003C/em> 2023;18(2):e0279463.\u003C/li>\n\u003Cli>Robinson N, Delorenzo A, Howell S, et al. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/37259203/\" target=\"_blank\" rel=\"noopener\">Pediatric distraction tools for prehospital care of pain\u003C/a> \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/37259203/\" target=\"_blank\" rel=\"noopener\">and distress: A systematic review\u003C/a>. \u003Cem>Pediatrics.\u003C/em> 2023;152(1):e2022059910.\u003C/li>\n\u003Cli>\u003Cstrong>Poonai N, Creene C, Dobrowlanski A, et al. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/37171705/\" target=\"_blank\" rel=\"noopener\">Inhaled nitrous oxide for painful \u003C/a>\u003Ca href=\"https://cps.ca/en/documents/position/managing-pain-and-distress\" target=\"_blank\" rel=\"noopener\">procedures\u003C/a>\u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/37171705/\" target=\"_blank\" rel=\"noopener\"> in\u003C/a> \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/37171705/\" target=\"_blank\" rel=\"noopener\">children and youth: A systematic review and meta-analysis\u003C/a>. \u003Cem>CJEM.\u003C/em> 2023;25(6):508-28.\u003C/strong>\u003C/li>\n\u003Cli>Goren K, Cen Y, Montemurri V, et al. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/37287483/\" target=\"_blank\" rel=\"noopener\">The impact of music, play, and pet therapies in managing\u003C/a> \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/37287483/\" target=\"_blank\" rel=\"noopener\">pain and anxiety in paediatric patients in hospital: A rapid systematic review\u003C/a>. \u003Cem>Paediatr Child\u003C/em> \u003Cem>Health.\u003C/em> 2023;28(4):218-24.\u003C/li>\n\u003Cli>Zaki HA, Elarref MA, Iftikhar H, et al. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/36523723/\">Efficacy of EMLA (eutectic mixture of local anaesthetics) and let (lidocaine, epinephrine, tetracaine) for topical use in wound management for children: A systematic review and meta-analysis.\u003C/a> \u003Cem>Cureus.\u003C/em> 2022;14(11):e31447.\u003C/li>\n\u003Cli>Taddio A, McMurtry CM, Logeman C, et al. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/36283899/\" target=\"_blank\" rel=\"noopener\">Prevalence of pain and fear as barriers to vaccination\u003C/a> \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/36283899/\" target=\"_blank\" rel=\"noopener\">in children – systematic review and meta-analysis\u003C/a>. \u003Cem>Vaccine.\u003C/em> 2022;40(52):7526-37.\u003C/li>\n\u003Cli>Lluesma-Vidal M, Carcelén González R, García-Garcés L, et al. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/35943776/\">Effect of virtual reality on pediatric pain and fear during procedures involving needles: Systematic review and meta- analysis.\u003C/a> \u003Cem>JMIR Serious Games.\u003C/em> 2022;10(3):e35008.\u003C/li>\n\u003Cli>Kyriakidis I, Tsamagou E, Magos K. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/33710698/\" target=\"_blank\" rel=\"noopener\">Play and medical play in teaching pre-school children to cope\u003C/a> \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/33710698/\" target=\"_blank\" rel=\"noopener\">with medical procedures involving needles: A systematic review\u003C/a>. \u003Cem>J Paediatr Child Health.\u003C/em> 2021;57(4):491-9.\u003C/li>\n\u003Cli>Cozzi G, Valerio P, Kennedy R. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/32772423/\" target=\"_blank\" rel=\"noopener\">A narrative review with practical advice on how to decrease pain\u003C/a> \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/32772423/\" target=\"_blank\" rel=\"noopener\">and distress during venepuncture and peripheral intravenous cannulation\u003C/a>. \u003Cem>Acta Paediatr.\u003C/em> 2021;110(2):423-32.\u003C/li>\n\u003Cli>\u003Cstrong>Poonai N, Spohn J, Vandermeer B, et al. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/31862730/\" target=\"_blank\" rel=\"noopener\">Intranasal dexmedetomidine for procedural\u003C/a> \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/31862730/\" target=\"_blank\" rel=\"noopener\">distress in children: A systematic review\u003C/a>. \u003Cem>Pediatrics.\u003C/em> 2020;145(1):e20191623.\u003C/strong>\u003C/li>\n\u003Cli>Lambert V, Boylan P, Boran L, et al. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/33089901/\" target=\"_blank\" rel=\"noopener\">Virtual reality distraction for acute pain in children\u003C/a>. \u003Cem>Cochrane Database Syst Rev.\u003C/em> 2020;10(10):CD010686.\u003C/li>\n\u003Cli>Gates M, Hartling L, Shulhan-Kilroy J, et al. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/31969473/\" target=\"_blank\" rel=\"noopener\">Digital technology distraction for acute pain in\u003C/a> \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/31969473/\" target=\"_blank\" rel=\"noopener\">children: A meta-analysis\u003C/a>. \u003Cem>Pediatrics.\u003C/em> 2020;145(2):e20191139.\u003C/li>\n\u003Cli>Birnie KA, Noel M, Chambers CT, Uman LS, Parker JA. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/30284240/\" target=\"_blank\" rel=\"noopener\">Psychological interventions for needle-\u003C/a> \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/30284240/\" target=\"_blank\" rel=\"noopener\">related procedural pain and distress in children and adolescents\u003C/a>. \u003Cem>Cochrane Database Syst Rev.\u003C/em> 2018;10(10):CD005179.\u003C/li>\n\u003Cli>McMurtry CM, Noel M, Taddio A, et al. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/26352916/\" target=\"_blank\" rel=\"noopener\">Interventions for individuals with high levels of needle fear\u003C/a>: \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/26352916/\" target=\"_blank\" rel=\"noopener\">Systematic review of randomized controlled \u003C/a>\u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/19781436/\" target=\"_blank\" rel=\"noopener\">trials and quasi-\u003C/a>\u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/33683617/\" target=\"_blank\" rel=\"noopener\">randomized controlled trial\u003C/a>\u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/19781436/\" target=\"_blank\" rel=\"noopener\">s\u003C/a>. \u003Cem>Clin J Pain.\u003C/em> 2015;31(10 Suppl):S109-23.\u003C/li>\n\u003Cli>Taddio A, Ilersich AL, Ipp M, et al. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/19781436/\">Physical interventions and injection techniques for reducing injection pain during routine childhood immunizations: Systematic review of randomized controlled trials and quasi-randomized controlled trials.\u003C/a> \u003Cem>Clin Ther.\u003C/em> 2009;31(Suppl 2):S48-76.\u003C/li>\n\u003C/ol>\n",{"__typename":1184,"title":1207,"subTitle":1192,"content":1219},"\u003Col>\n\u003Cli>Ali S, Hudson S, Rajagopal M, et al. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/40962105/\" target=\"_blank\" rel=\"noopener\">A Randomized Controlled Trial of Commercially Available\u003C/a> \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/40962105/\" target=\"_blank\" rel=\"noopener\">Virtual Reality for Intravenous Cannulation-Related Distress in Children\u003C/a>. \u003Cem>J Pediatr.\u003C/em> 2026;288:114803.\u003C/li>\n\u003Cli>\u003Cstrong>Tsze DS, Woodward HA, McLaren SH, et al. \u003Ca href=\"https://doi.org/10.1001/jamapediatrics.2025.2181\" target=\"_blank\" rel=\"noopener\">Optimal Dose of Intranasal Midazolam for\u003C/a> \u003Ca href=\"https://doi.org/10.1001/jamapediatrics.2025.2181\" target=\"_blank\" rel=\"noopener\">Procedural Sedation in Children: A Randomized Clinical Trial\u003C/a>. \u003Cem>JAMA Pediatr.\u003C/em> 2025;179(9):979–86.\u003C/strong>\u003C/li>\n\u003Cli>\u003Cstrong>Wang JY, Speechley K, Anderson KK, et al. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/39198327/\" target=\"_blank\" rel=\"noopener\">Intranasal midazolam for procedural distress in\u003C/a> \u003Ca href=\"https://www.nejm.org/doi/pdf/10.1056/NEJMvcm1411127?articleTools=true.\" target=\"_blank\" rel=\"noopener\">children\u003C/a>\u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/39198327/\" target=\"_blank\" rel=\"noopener\"> in the emergency department: a \u003C/a>\u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/36523723/\" target=\"_blank\" rel=\"noopener\">systematic review and meta-\u003C/a>\u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/35943776/\" target=\"_blank\" rel=\"noopener\">analysis\u003C/a>. \u003Cem>CJEM.\u003C/em> 2024;26(9):658-70.\u003C/strong>\u003C/li>\n\u003Cli>Wong CL, Choi KC. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/36795410/\" target=\"_blank\" rel=\"noopener\">Effects of an immersive virtual reality intervention on pain and anxiety among\u003C/a> \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/36795410/\" target=\"_blank\" rel=\"noopener\">pediatric patients undergoing venipuncture: A randomized clinical trial\u003C/a>. \u003Cem>JAMA Netw Open.\u003C/em> 2023;6(2):e230001.\u003C/li>\n\u003Cli>Scribner-O’Pray M, Taylor ED, Krause E, Nickel A, Bergmann KR. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/35608526/\" target=\"_blank\" rel=\"noopener\">Factors associated with low\u003C/a> \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/35608526/\" target=\"_blank\" rel=\"noopener\">procedural pain scores among 1- to 5-year-old patients undergoing facial laceration repair\u003C/a>. \u003Cem>Pediatr Emerg Care.\u003C/em> 2023;39(3):135-41.\u003C/li>\n\u003Cli>Poonai N, Sabhaney V, Ali S, et al. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/36870890/\" target=\"_blank\" rel=\"noopener\">Optimal dose of intranasal dexmedetomidine for laceration\u003C/a> \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/36870890/\" target=\"_blank\" rel=\"noopener\">repair in children: A phase ii dose-ranging study\u003C/a>. \u003Cem>Ann Emerg Med.\u003C/em> 2023;82(2):179-90.\u003C/li>\n\u003Cli>Kleye I, Sundler AJ, Karlsson K, Darcy L, Hedén L. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/36911787/\" target=\"_blank\" rel=\"noopener\">Positive effects of a child-centered\u003C/a> \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/36911787/\" target=\"_blank\" rel=\"noopener\">intervention on children’s fear and pain during needle \u003C/a>\u003Ca href=\"https://cps.ca/en/documents/position/managing-pain-and-distress\" target=\"_blank\" rel=\"noopener\">procedures\u003C/a>. \u003Cem>Paediatr Neonatal Pain.\u003C/em> 2023;5(1):23-30.\u003C/li>\n\u003Cli>Siembieda J, Heyming T, Padlipsky P, Young KD. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/35100752/\" target=\"_blank\" rel=\"noopener\">Triple versus single application of lidocaine, \u003C/a>\u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/35100752/\" target=\"_blank\" rel=\"noopener\">epinephrine, and tetracaine for laceration repair in children\u003C/a>. \u003Cem>Pediatr Emerg Care.\u003C/em> 2022;38(2):e472-4.\u003C/li>\n\u003Cli>Moline RL, Constantin K, Chambers CT, et al. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/36553313/\" target=\"_blank\" rel=\"noopener\">A brief mindfulness intervention for parents and\u003C/a> \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/36553313/\" target=\"_blank\" rel=\"noopener\">children before pediatric venipuncture: A \u003C/a>\u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/33683617/\" target=\"_blank\" rel=\"noopener\">randomized controlled trial\u003C/a>. \u003Cem>Children (Basel).\u003C/em> 2022;9(12):1869.\u003C/li>\n\u003Cli>Lee HN, Hwang S, Jung JY, et al. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/35510723/\" target=\"_blank\" rel=\"noopener\">Tablet personal computer distraction during intravenous\u003C/a> \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/35510723/\" target=\"_blank\" rel=\"noopener\">placement for young children in the pediatric emergency department: A pilot study\u003C/a>. \u003Cem>Pediatr Int.\u003C/em> 2022;64(1):e15150.\u003C/li>\n\u003Cli>Kammerer E, Eszczuk J, Caldwell K, et al. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/36553240/\" target=\"_blank\" rel=\"noopener\">A qualitative study of the pain experiences of children\u003C/a> \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/36553240/\" target=\"_blank\" rel=\"noopener\">and their parents at a Canadian children’s 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2018;2(1):292-301.\u003C/li>\n\u003Cli>Gouin S, Gaucher N, Lebel D, Desjardins MP. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/29108736/\" target=\"_blank\" rel=\"noopener\">A randomized double-blind trial comparing the\u003C/a> \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/29108736/\" target=\"_blank\" rel=\"noopener\">effect on pain of an oral sucrose solution vs. Placebo in children 1 to 3 months old undergoing\u003C/a> \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/29108736/\" target=\"_blank\" rel=\"noopener\">simple venipuncture\u003C/a>. \u003Cem>J Emerg Med.\u003C/em> 2018;54(1):33-9.\u003C/li>\n\u003Cli>Olsen K, Weinberg E. \u003Ca href=\"https://www.sciencedirect.com/science/article/pii/S1522840117300095\" target=\"_blank\" rel=\"noopener\">Pain-less practice: Techniques to reduce procedural pain and anxiety in \u003C/a>\u003Ca href=\"https://www.sciencedirect.com/science/article/pii/S1522840117300095\" target=\"_blank\" rel=\"noopener\">pediatric acute care\u003C/a>. 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E\u003Cem>merg Med Australas\u003C/em>. 2013;25(2):161-167.\u003C/strong>\u003C/li>\n\u003Cli>Stevens BJ, Abbott LK, Yamada J, et al. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/21464171/\" target=\"_blank\" rel=\"noopener\">Epidemiology and management of painful procedures in\u003C/a> \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/21464171/\" target=\"_blank\" rel=\"noopener\">children in Canadian hospitals\u003C/a>. \u003Cem>CMAJ.\u003C/em> 2011;183(7):e403-10.\u003C/li>\n\u003Cli>Babl FE, Goldfinch C, Mandrawa C, et al. \u003Ca href=\"https://pubmed.ncbi.nlm.nih.gov/19482767/\">Does nebulized lidocaine reduce the pain and distress of nasogastric tube insertion in young children? 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Infographic: Analgesia & sedation of paediatric ileocolic intussusception: A global multicentre study. 2023.\u003C/li>\n\u003Cli>Trottier E, Doré-Bergeron MJ, Chauvin-Kimoff L, Baerg K, Ali S. \u003Ca href=\"https://www.pedscases.com/managing-pain-and-distress-children-undergoing-brief-diagnostic-and-therapeutic-procedures-cps\">Managing pain and distress in children undergoing brief diagnostic and therapeutic procedures – CPS podcast.\u003C/a> Stollery Children’s Hospital: Peds Cases. 2019.\u003C/li>\n\u003Cli>Krauss BA, Krauss BS. \u003Ca href=\"https://www.sciencedirect.com/science/article/pii/S0196064418315609?via%3Dihub.\" target=\"_blank\" rel=\"noopener\">Managing the frightened child\u003C/a>. \u003Cem>Ann Emerg Med.\u003C/em> 2019;74(1):30-5.\u003C/li>\n\u003Cli>Krauss BS, Krauss BA, Green SM. \u003Ca href=\"https://www.nejm.org/doi/pdf/10.1056/NEJMvcm1411127?articleTools=true.\">Videos in clinical medicine. Managing procedural anxiety in children.\u003C/a> \u003Cem>N Engl J Med.\u003C/em> 2016;374(16):e19.\u003C/li>\n\u003C/ol>\n",{"edges":1224},[1225],{"cursor":541,"node":1226},{"name":29,"link":32,"slug":1227},"healthcare-providers",{"edges":1229},[1230],{"cursor":688,"node":1231},{"name":552,"link":1232,"slug":690},"https://cms.trekk.ca/topic/procedural-fear-and-anxiety/",{"edges":1234},[1235],{"cursor":1236,"node":1237},"YXJyYXljb25uZWN0aW9uOjE1",{"name":1194,"slug":1238},"evidence-repository",{"debug":1240,"queryAnalyzer":1241},[],{"keys":1242,"keysLength":1243,"keysCount":1244,"skippedKeys":680,"skippedKeysSize":681,"skippedKeysCount":681,"skippedTypes":1245},"a19e325deaecb13c17ce6fb1a52918ee57d214f068e8c68da00591083d72a3e5 graphql:Query cG9zdDo0OTYx cG9zdDo0OTY1 cG9zdDo0OTY2 cG9zdDo0OTYy dGVybToyMA== dGVybTo0ODE= dGVybToxNQ==",169,9,[],1788995732996]