What is it?
A PCA is a way of giving strong pain relieving medication (such as morphine) to children after a painful operation or during a painful illness when they are in hospital.
The medicine is given through a plastic tube called a cannula (drip), which has usually been inserted into your child’s hand, arm or foot. The child is in control of how much medicine they get, which means they do not need to wait for a nurse to get it.
How does it work?
An electric pump is programmed by an anaesthetist to deliver the correct amount of medication when the PCA button is pressed.
A tube is attached to the cannula and the child can press the button when they are in pain. This activates the pump to deliver a dose of pain medicine and then stops a further dose being delivered for a short time. The pump usually makes a ‘beep’ noise when a dose has been delivered.
It is usually takes about 5 to 10 minutes for the medication to start to work. The child can press the button as many times as they need to, depending on how much pain they have.
Can anyone have a PCA?
A PCA is usually given to children who are old enough to understand that they are in pain and that they will be in control of their own pain relieving medication.
Children who have a PCA must also be able to physically press the button themselves. Only the child is allowed press the button.
Is it safe?
The pump is programmed so that the child cannot give themselves too much pain relieving medication. Once the button has been pressed and a dose of medication has been delivered, the pump will not deliver anymore medication for a set time (usually 5 minutes), even if the button is pressed again.
The button has a green light that will come on when the ‘lockout’ time has passed and the pump is ready to give another dose if needed.
Strong pain medications, such as morphine, can make you feel sleepy and so if your child uses the PCA a lot and falls asleep, they will not be able to press the button to give themselves more pain medicine. This is why it is very important that no-one else presses the button. If you did, you could cause breathing problems for the child.
The nurses on the ward will monitor your child while they have the PCA. They will check how well their pain is being controlled, how drowsy they are as well as their heart rate, breathing, oxygen levels and blood pressure.
What are the side effects?
Morphine and morphine-like medicines are used in PCAs. Children may experience nausea or vomiting, drowsiness, itchiness, dizziness, slow breathing or strange dreams. The child will be monitored for these but if you have any concerns please do speak to the ward nurses.
What if it does not work?
The nurses will check the how well pain is being controlled. If the PCA is not working well enough, the pain team or an anaesthetist will be contacted. The pump can be adjusted to increase the dose or other options may be available.
How long can it be used for?
A PCA is usually used between 2 and 5 days, but can be used longer if required. As pain improves, the PCA will be needed less and the child will use the button less often. They can then take different pain medicines, usually given by mouth, to treat any pain.
South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.
This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.