Nursing care based on facial expressions of infants under sedation in pediatric intensive care units

Abstract

 Purpose: To demonstrate how nurses observe and utilize the facial expressions of infants in the PICU under sedation for caregiving purposes.

 Method: Leininger’s Transcultural Nursing Theory was applied. The study infants comprised eight nurses in addition to general information providers comprising nine families with infants and five doctors.

 Results: 1. If a “grim” expression persisted, nurses tried to identify the most suitable depth of sedation to address possible causes of sleeplessness. 2. If the infant’s eyes were closed but the mouth was moving, nurses tried to maintain the infant’s breathing stability while anticipating a possible unplanned extubation. 3. If an “empty gaze” was present three hours after coming off sedative medication, nurses anticipated a worsening of clinical condition and responded to prevent acute deterioration. 4. If the expression was “limp” and “with signs of distress” after being awakened, nurses anticipated impact in the area of breathing and circulation, and prioritized the maintenance of restfulness.

 Discussion: During sedation, nurses watch for subtle changes in expression in the area between the eyebrows, or near the eyes, and the mouth, to anticipate a possible abnormality in the coming hours and determine the care needed at that time.