final program

IMPORTANT: All Workshops should be case-based, i.e. authentic clinical cases and scenario’s are used for interactive discussion. Use of slides should be limited to present cases and short summaries of essential learning points. Please do not give (mini)lectures during the workshop. Use of videography (i.e. filmed authentic cases) is strongly recommended.

DAY 1 Workshops

Workshop 1: 'Virtual World'

• Non-pharmacological strategies to help children lying still during imaging procedures (e.g. MRI scanning). Immersive and Virtual Realty techniques for Medical Procedures.

Workshop 2: ‘No more Tears’

• Many claim offering a patient-centered service when dealing with distressing procedures in children. But how much choice do we really grant to children and their parents? And how can we make patients/parents competent for making appropriate choices that contribute to optimal procedural perceptions and experiences?
• Anna Taddio developed with her team a method for active knowledge translation so that children/parents themselves can learn which methods work best for them. From the University of Toronto Website: “In the past, we’ve burdened the health-care provider with everything,” says Taddio. “But I think it’s better to show the kids and then they can choose how to best cope. In the end, Taddio says it’s all about medical community acknowledging the existence of pain and working with patients to reduce its impact during injections and other procedures. Treating pain has many benefits,” she says. “It not only prevents unnecessary suffering, it ensures we are delivering the best care possible, improves everyone’s satisfaction with the experience, and improves health because people are more likely to participate in positive health behaviours like getting vaccinated and going to a doctor to get a blood test to look for high cholesterol and these sorts of things.” (https://www.utoronto.ca/news/no-more-tears-publicly-funded-research-u-t-s-anna-taddio-taking-pain-out-vaccinations-canada)

Workshop 3: ‘Not just a Poke’

• Correct use of topical anesthetics (location, timing, tips – tricks, logistical challenges)
• Misconceptions (e.g. emla generates more failure of IV access)
• Other techniques (cooling, J-tip, subcutaneous infiltration of buffered lidocaine with a 30G needle, Buzzy,...): evidence, experiences, practices...

Workshop 4: ‘Stitches and Fractures’.

• How to create an ouchless ER
• Suggested procedures to discuss/to use for discussion: Wound care and suturing; Non-complex forearm fracture; Abscess drainage
• Points for discussion: patient approach; optimal local/topical techniques; when to use sedation? Which sedation (important point to discuss: indications versus limitations of nitrous oxide)
• IMPORTANT: Is Fentanyl (IN or IV) on its own sufficiently effective for fracture reduction or similar painful procedures?
• Key questions a professional should ask him/herself before starting procedures: (1) Is the child in pain before (i.e. in need for acute pain management). (2) Environmental setting. (3) Adaptive distraction possible? (4) How painful is the procedure anticipated by you, the family/child? (4) Use of topical analgesics. (5) Most optimal additional sedative (anxiolysis or deep sedation?)

Workshop 5: ‘Changing the Talk of Town’.

• Changing the way we talk as professionals with patients and with eachother
• Which words/sentences may harm and which kind of talk might enhance trust and feelings of comfort?

Workshop 6: ‘The Child with medical psycho-trauma’: The use of EMDR in the clinical setting

• Managing anticipatory Anxiety; Cognitive Behavioral Strategies; Desensitization
• What does ‘trauma’ mean
• Iatrogenic Post-Traumatic Stress Disorder; EMDR therapy

Workshop 7: 'Art Therapy' as support for children during medical procedures

DAY 2 Workshops

Workshop 8: 'Language – Suggestion – Hypnosis'

• How can words and suggestions influence patientcomfort?
• What is hypnosis?
• How can children use self-hypnosis to reduce their pain and anxiety?

Workshop 9: 'Comfort strategies for Common Distressing Procedures – Clinical Cases I'

• IV access
• Nasogastric tubes
• Urinary Catheters

Workshop 10: 'Sedation for radiologic imaging - Clinical Cases II: '

• Which children will need sedation? Which may benefit from non-pharmacology [Refer to Workshop 1 – Day 1]?
• Best practice for < 3-6 months; 6m-5 yrs; > 5 yrs
• Propofol? Dexmedetomidine (IV? IN? Doses?)
• Patient-centered sedation care on a radiology department. What is needed?

Workshop 11: 'Comfort Strategies in special needs children and children with autism spectrum disorder -Clinical Cases III'

• For example: autism spectrum disorder, severe anxiety, hyperactivity, mental retardation,...
• How to involve parents/caretakers?
• Which drugs might be more optimal?

Workshop 12: 'Capnography – practical exercises'

• Practical applications of capnography during dissociative and deep sedation
• Airway assessment: Using the waveform to detect normal ventilation abnormal ventilation including hypoventilation/respiratory depression, obstructive apnea (upper airway obstruction, laryngospasm), central apneas, and bronchospasm.

Workshop 13: 'Setting up a sedation Service in your hospital'

• Which conditions are needed (evidence-based protocols; transparency; inter-disciplinary collaboration; consistent care)
• Introducing TROOPS
• How to achieve a patient-centered service offering care tailored to individual comfort needs

Workshop 14: 'Keeping Nitrous Oxide Safe for All – Measures for Controlling Occupational Exposure'

• Occupational toxicity of Nitrous Oxide and risks for Healthcare workers
• Measure to control occupational exposure