The American Academy of Pediatrics (AAP) has issued a report stressing the importance of alleviating children’s pain and anxiety when they require emergency room treatment. Published online Oct. 29, the new report will appear in the November print issue of the AAP journal Pediatrics.
As reported by HealthDay, barriers to providing effective pain treatment for children in the ER exist. Physicians are concerned about the adverse effects of medication or that drugs will mask the pain and make it more difficult to arrive at a diagnosis. Overworked staff in a busy ER may mean pain levels are not adequately addressed.
According to medpagetoday.com, the AAP report suggests that these barriers can be overcome. In addition to administering pain relief before a child gets to the hospital if transported by ambulance, the organization offers the following recommendations for providing optimal pain and stress management for children in the emergency room:
- Initial evaluation of a child in the ER should include an assessment of pain using a numerical scale or, for young children, the FACES pain scale, in which patients indicate which face best represents the degree of pain they are experiencing.
- Protocols should be in place to guide the administration of medications such as ibuprofen, acetaminophen, or oral narcotics, as well as the use of topical anesthetics to numb areas for likely painful procedures, including IV line placement, suturing or spinal puncture.
- For infants, pain should be alleviated with topical anesthetics or having the child suck on a sucrose solution from a pacifier immediately before a procedure.
- To help alleviate the child’s stress, family members should be allowed to be present, ideally in a child-friendly room that provides comforting distractions.
A child in pain, a busy emergency department (ED) and overworked doctors are all the source of unmitigated stress for all concerned. It is also precisely the time when parents need to remain calm and become an advocate for their child.
“Nobody knows your child like you know your child. You’re the first line of defense,” Audrey Paul, MD, pediatric ER physician and associate professor of emergency medicine at Mount Sinai School of Medicine in New York City, told NBC News. “You see them at their most vulnerable point, and you see them when they are normal.”
According to Paul, advocating may sometimes be the only way to get relief for children in pain. “[Emergency departments] are so busy and overcrowded that their pain may not be in the forefront of the doctor’s or nurse’s consciousness,” she added.
The good news is that the report authors are optimistic about the changes needed to provide children in the emergency department with optimum pain management.
“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,” wrote report authors.