Pediatric Pain Management Toolbox
The Emergency Medical Services for Children (EMSC) Program’s grantees and pediatric researchers work hard to increase health professionals’ knowledge and recognition of the characteristic indications of pain in children, as well as the immediate and long-term consequences for children when pain is unrecognized and untreated. We applaud the men and women who strive to understand, assess, and relieve children’s pain in the prehospital and in the emergency department setting.
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HEALTHCARE PROVIDER RESOURCES American Academy of Pediatrics
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EXAMPLE PRACTICES
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DATABASE SEARCHES National Library of Medicine PubMed journal article database Click here for the PubMed pre-populated search string. PubMed Link doesn't work? Try PubMed Troubleshooting |
FAMILY AND CAREGIVER RESOURCES
More details about this and other family and caregiver resources |
HEALTHCARE PROVIDER RESOURCES
American Academy of Pediatrics
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Relief of Pain and Anxiety in Pediatric Patients in Emergency Medical Systems. This Clinical Report from the American Academy of Pediatrics (AAP) provides information to optimize pain relief and stress reduction for children requiring emergency care. (November 2004)
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Prevention and Management of Pain and Stress in the Neonate. In this updated policy statement, the AAP recommends safe and effective interventions for preventing and relieving pain in neonates. (November 2006)
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The Assessment and Management of Acute Pain in Infants, Children, and Adolescents. This 2001 statement, developed in conjunction with the American Pain Society (APS), underscores the responsibility of pediatricians to take a leadership and advocacy role to ensure humane and competent treatment of pain and suffering in all infants, children, and adolescents. (September 2001)
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Special Considerations: Pain in Specific Populations. This resource contains a “Children and Pain” section that discusses: (1) common causes of pain in children, (2) myths and truths about pediatric pain, and (3) potential barriers to effective pain treatment. (November 2008)
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Pediatric Pain Management. Recognizing that knowledge about pediatric pain management is not always translated effectively into clinical practice, the American Medical Association developed this educational module to: (1) describe developmentally appropriate strategies and tools for assessing pain in children, and (2) provide education on the utilization of pharmacologic and non-pharmacologic treatments for pain in children. (September 2009)
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Pediatric Pain – Science Helping Children. Canada’s Center for Pediatric Pain Research maintains this comprehensive listing of online pain resources. The site contains a variety of links for professionals and researchers, in addition to those directly affected by pediatric pain. (Accessed May 2010)
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Pediatric Pain Resources. This section of the Mayday Pain Project’s website link to both education- and example- based resources to help healthcare professionals and others learn about pediatric pain issues and care strategies. (Accessed May 2010)
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Psychology and Pediatric Pain. This section of the National Pain Foundation website provides information on the psychological factors associated with pain in children and adolescents. It addresses evaluation and treatment strategies, as well as proposed self-management techniques for pain. (Accessed May 2010)
New York University Pain Management Center
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Pediatric Pain. Designed for healthcare practitioners, this website contains clinical information regarding pain measurement in adults and pediatric patients, pharmacological considerations, analgesics, and psychological evaluation/treatment. (Accessed May 2010)
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Oucher Pain Scale. Designed to help assess pediatric pain levels, this resource presents photographs of children making pained expressions of varying intensity, corresponding to a 10-point scale. Choosing a face and a number helps children ages 1-12 communicate their discomfort level to the doctor or nurse providing care. Additional information on how to use the Oucher Scale is also available. (Accessed May 2010)
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Pediatric Pain Reference Cards. The University of Rochester’s Pediatric Subcommittee developed this comprehensive resource to aid in the assessment of pain in children of varying ages, describe pharmacologic and non-pharmacologic management strategies, and provide dosing information for common analgesics and sedatives. (November 2005)
EXAMPLE PRACTICES
Illinois EMSC. Illinois EMSC is a collaborative program between the Illinois Department of Public Health and Loyola Medical Center. The goal of the program is to ensure that appropriate emergency medical care is available for ill and injured children at every point along the continuum of care. Recognizing that pain management is a fundamental component of quality emergency care for children, the program has developed the educational modules and slide shows detailed below.
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Pediatric Pain Management in the Emergency Department: Online Educational Module. This module provides an overview of the essential components of pediatric pain management. It addresses pain management standards, barriers and misconceptions, physiologic pain response in children, pharmacologic and non-pharmacologic management of pediatric pain, healthcare professional educational recommendations, patient/family education, and quality improvement activities. The module is designed for online use by an individual for educational credit as well as for off-line use in a group setting for nurses, physicians, and prehospital providers. (Accessed May 2010)
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Pediatric Pain Management in the Emergency Department: Slide Show. Again designed for educational purposes, this resource describes common interventions, procedures, and techniques for managing pain in children. It also provides mechanisms for assessing pain in pediatric patients of different ages and cultural/racial/ethnic backgrounds, as well as children with special healthcare needs. (Accessed May 2010)
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Pediatric Pain Management in the Emergency Department: An Executive Summary. In 2005, 121 emergency departments (ED) actively participated in the EMSC regional CQI program. These EDs were surveyed regarding pediatric pain management using a web-based application. Of the 121 facilities, 93 (77%) completed the survey. In addition, the respondents conducted 792 medical record reviews on pediatric patients age 0-15 years who presented to the ED with extremity fracture(s). After data submission, participants were provided with web-based reports that allowed comparison of their results to their region, to similar sized facilities, and to the rest of the state. For this executive summary, responses from the 2005 web-based application were compared to their responses to paper-based surveys from 2002 and 2003. In addition, comparisons were made among facilities by grouping their responses according to their EMS Regions. (2006)
Children’s Hospitals and Clinics of Minnesota. The Children’s Hospitals and Clinics of Minnesota’s Pain and Palliative Care Program is a model for pain management across the entire continuum of pediatric patient care. The program aims to provide seamless inpatient, home, and hospice care for children experiencing acute or chronic pain, or living with life-limiting medical conditions. A multidisciplinary team – including the child’s physician, family members, specialty-care providers, nurses, social workers, child life specialists, chaplains, and volunteers – works together to address the child’s pain and provide coping mechanisms for the family. Components and aspects of the program include (each assessed May 2010):
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The Perinatal Hospice Program, and
Mattel Children’s Hospital at UCLA. Mattel Children’s Hospital at the University of California – Los Angeles (UCLA) has developed a Pediatric Pain Program, an interdisciplinary program that includes research, clinical service, and education. It is based within a mind-body framework that takes into account the complex interaction between physiology, emotions, cognitions, and the environment in all aspects of clinical evaluation and treatment, as well as in research.
The research program has three areas of focus: 1) pain and other symptoms, 2) young adult survivors of childhood cancer and the pediatric cancer experience in general, and 3) complementary and alternative medicine.
The clinical program is designed to evaluate and treat infants, children, adolescents, and young adults who have complex chronic pain or other ongoing symptoms. Treatments typically integrate more traditional medicine with other complementary and alternative medicine clinical services.
The pain educational program typically has several post-doctoral research fellows, as well as graduate, undergraduate, and medical students engaged in research projects. Electives are offered for residents from different training backgrounds to enhance their education in treating pain. (Accessed May 2010)
FAMILY AND CAREGIVER RESOURCES
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How Do I Know My Child Has Pain? This section of the AboutKidsHealth website aims to help parents and caregivers identify and cope with children’s pain. The site provides information on recognizing pain, helping children describe pain, and pain management strategies – both physical and psychological. (Accessed May 2010)
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Pain Assessment. This section of the AboutKidsHealth website supplies information on components of pain assessment in children. The site includes lists of questions that caregivers should ask hurting children, as well as any observers, to better understand the intensity and type of pain. (September 2009)
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About Pain. This site explains the physiological basis for pain – including neurological components – and describes the connection between pain and emotion in children of varying ages. (September 2009)
Cincinnati Children’s Hospital
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Manejo del Dolor (Pain Management). This resource helps Spanish speaking families to understand the causes of pediatric pain, as well as common mechanisms for measuring and treating children experiencing pain and stress. (September 2009)
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Why Do I Have Pain? Through this online resource, children have the opportunity to learn the physical causes of pain in their bodies, as well as why people experience pain. (Accessed May 2010)
University of Iowa Children’s Hospital
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Helping Your Child with Pain Control. Parents bring special knowledge of their children's needs to the health care team and are very important partners in their children's pain management. This resource assists parents and caregivers in working with healthcare providers to help identify and manage their children’s pain. (March 2008)
University of Michigan Health System
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Pain and Your Child or Teen. Designed specifically for parents and caregivers, this website helps adults understand the definitions and causes of pain in children and adolescents. It includes links to resources for measuring and managing pain, learning about pain medication and non-drug treatments, and exploring specific types of pain. Alternative pain management strategies, such as breathing techniques, massage, distraction, and virtual reality, are discussed. (Accessed May 2010)