Pediatric Pain Management Toolbox

Emergency Medical Services for Children (EMSC) Program 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.

HEALTHCARE PROVIDER RESOURCES

American Academy of Pediatrics

• Relief of Pain and Anxiety in Pediatric Patients in Emergency Medical Systems. This Clinical Report of the American Academy of Pediatrics provides information to optimize the comfort of children whether they are cared for in the emergency setting or other environments. (2004)

American Academy of Pain Management

• Pain Management Resources. The American Academy of Pain Management is an inclusive, interdisciplinary organization serving clinicians who treat people with pain through education, setting standards of care, and advocacy. This web site contains publications, CME courses, and information on how to locate a pain professional. (Accessed October 2008)

The Cleveland Clinic

• The Clinic’s website includes information on treating pain in children, pain measurement in children, and considerations when using drugs to treat pain in children. (Accessed October 2008)

• Pediatric Pain Management In The Emergency Department Educational Module. The Pediatric Pain Management in the Emergency Department Educational 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 October 2008)

Mayday Fund

• Pediatric Pain Grants. The Mayday Fund is dedicated to alleviating human physical pain by providing pain-related grants. The Fund’s website includes pain-focused resources and information on its grantees including projects such as the Iowa Pediatric Pain Rural Emergency Department Network’s, which seeks to address pediatric pain assessment and management in rural emergency departments. (Accessed October 2008)

The National Pain Foundation

• The Foundation’s website includes information on the psychological factors related to chronic pain in children and adolescents. (Accessed October 2008)

Oucher 

• Oucher Pain Scale Resource. The Oucher is a poster showing photographs of children making faces in pain next to a 10-point scale. Choosing a face and a number helps children ages 1 to 12 years who are in pain to communicate their discomfort level to the nurse or doctor responsible for his or her assessment and management. (Accessed October 2008)

University of Michigan Health System

• The University’s website covers pediatric pain management including dispelling common myths, basic concepts, pain assessment, pain scales, documentation, classification of pain by inferred pathology, common side effects from opioids, and non-pharmacological approaches to pain. (Accessed October 2008)

EXAMPLE PRACTICES

• Pediatric Advanced Care Team. Since 1997, the Pediatric Advanced Care Team (PACT) has supported children treated at Children’s Hospital Boston and Dana-Farber Cancer Institute. The team includes two doctors, a nurse, a social worker, and a coordinator. PACT members consult with patients, families, and the primary care team to bring together the information and guidance needed to make the right treatment choices for each child. Some of the support they provide includes optimizing pain and symptom management, advocating family and healthcare provider communication, and coordinating inpatient, outpatient, and home care. (Accessed October 2008)

Children’s Hospitals and Clinics of Minnesota

• Pain and Palliative Care Program. The Pain and Palliative Care Program at Children’s Hospitals and Clinics of Minnesota is a model for multidisciplinary inpatient, home and hospice care for children in acute and chronic pain and for children with life-limiting conditions. The multidisciplinary team includes the child’s physician, family, specially-trained physicians, nurses, social workers, child life specialists, chaplains, and volunteers. Everyone works together in the hospital or at home in an effort to relieve the suffering of the child and family. There are many parts of this program including the Inpatient Pain and Palliative Care Team, Pain Clinic, Home-based Palliative Care, Home-based Hospice Care, Perinatal Hospice Program, and Education and Outreach. (Accessed October 2008)

FAMILY AND CAREGIVER RESOURCES

AboutKidsHealth 

• This organization’s website contains numerous resources for parents including sections on understanding how we feel pain, explaining how medications work, and how you can tell if your child is in pain. (Accessed October 2008)

KidsHealth

• Why Do I Have Pain? “Why Do I Have Pain?” is an online resource, children learn how pain physically occurs in their bodies, as well as why people experience pain. (Accessed October 2008)

Yale-New Haven Children’s Hospital

• Pediatric Pain Coloring Book. “Color Me Pain Free” is a 28-page coloring and activity book intended to help ease children’s anxiety prior to scheduled medical exams. In the book, children learn about medical methods of pain prevention used during his spinal tap, as well as ways they can use his own imagination to direct his attention away from the procedure. (Accessed October 2008)