More research and innovation on child pain and stress reduction is needed

Nov 1 2004

Relief of pain and stress for children receiving emergency medical treatment is a vital, and readily available, component of care.

According to the new AAP clinical report, "Relief of Pain and Anxiety of Pediatric Patients in Emergency Medical Systems," advances in the recognition and treatment of pain in children over the past 20 years have led to improved pain management for acutely ill and injured children. However, such care still lags behind adult pain management.

Severe pain and stress can have long-lasting implications for children. For example, a newborn infant who undergoes a procedure with inadequate pain relief may suffer permanent changes in her response to and perceptions of pain. Posttraumatic stress disorder also can occur after painful procedures and medical experiences.

And yet there is no evidence that pain management masks symptoms, clouds mental status, or in any way prevents physicians from making adequate assessments and diagnosis, according to the report.

Immediate pain assessment for children, including newborns, should occur upon emergency department (ED) admission, according to the report, and every opportunity should be taken to use available methods of pain control during treatment, even for minor procedures.

The report also recommends:

• Training and educating ED staff in pediatric pain assessment and management.
• Creating more favorable, child-friendly EDs.
• Incorporating child life specialists, and other professionals trained in non-medication stress reduction, in the ED.
• Allowing a parent or caregiver to remain with the child during painful procedures.
• Reducing pain during the administration of analgesics and anesthetics.
• Providing sedation for patients undergoing painful or stressful ED procedures.

More research and innovation on child pain and stress reduction is needed, according to the report. As medications and technology evolve, EDs must continue to ensure that safe protocols and practices are in place for child pain management.