October 29, 2012
New Guidelines Alleviate Child’s Pain In The Emergency Room
Lee Rannals for redOrbit.com - Your Universe Online
The American Academy of Pediatrics is pushing for reductions in the stress and pain a child experiences during visits to the emergency room.
The organization published a new report in the journal Pediatrics emphasizing the importance of controlling pain and anxiety in children who are visiting the emergency room.
The report reviewed nearly 250 medical studies to help provide some guidelines on how to reduce pain and stress for babies and kids in the ER.
It outlines simple ways to reduce pain and stress, including the use of pain pills and numbing creams in the waiting room.
The American Academy of Pediatrics also recommends distracting kids with bubbles and sugar pacifiers during painful tests, or allowing family members to stick around to help keep them calm.
“Although there is no evidence that family presence decreases pain, their presence for procedures can decrease child distress,” the researchers wrote in their report.
They said that pain control in children lags behind, but in adult medicine it has made strides and come a long way.
"Recent advances in the approach and support for pediatric analgesia and sedation, as well as new products and devices, have improved the overall climate of the ED for patients and families in search of the 'ouchless' ED," the report authors observed.
They said doctors should assess the pain by taking into consideration a child's age, and developmental level by using the FACES pain scale. This scale identifies which facial expression most resembles his or her degree of discomfort.
The report said provision should be made for the safe administration of analgesics before the child reaches the hospital.
Methods of administering medication can also ease the pain and stress levels, as well as using agents like nitrous oxide, which have pain-relief properties and reduce anxiety.
Some agents are even using sedation in order to help alleviate pain, but also improve that the child will likely remain still during procedures.
"The most important part of providing safe sedation for children is the establishment of appropriate sedation systems and sedation training programs with credentialing guidelines for sedation providers that specifically address the core competencies required for the care of pediatric patients," Fein and colleagues stated.
The report also highlights the concern in evaluating and treating children with disabilities, who may have particular problems with communicating their feelings of pain, anxiety and fear. They recommend using "child life specialists" who are trained in dealing with stressful situations in children to help with kids who have these developmental problems.
"Multiple modalities are now available that allow pain and anxiety control for all age groups. Future research should concentrate on pharmacologic, nonpharmacologic, and device-related technology that can assist in reducing the pain and distress associated with medical procedures," the report concluded.