Definition and Overview

Paediatric pain management is a common health care service that involves helping children cope with pain that may arise due to acute trauma or chronic illness. This service is provided to neonates, infants, toddlers, and children who are 12 years old and below.

Pain is a fact of life, and all types of people including newborns and children are susceptible and capable of feeling and experiencing physical, mental, and emotional pain. The major difference between pain in adults and that of children is the level of understanding and manner of communication.

Adults are believed to have a much deeper comprehension of pain due to their many years of experience. Also, they are expected to be more capable to communicate than children, who may not be able to find the right words to describe the pain, let alone the symptoms.

Because of this, pain management among children is a multi-practitioner approach. This means the responsibility rests not only on the paediatricians but also on social workers, counsellors, psychiatrists, therapists, and other healthcare professionals who are expected to work as a team.

Paediatric pain management also involves the community, especially friends, family, and even school, since children interact with them often. It’s essential that they have the knowledge and at least basic education on how to help children manage pain. Paediatric pain management includes both outpatient and inpatient procedures, with healthcare professionals constantly monitoring their symptoms, diseases, and progress.

In the end, children are expected to continue living a good normal life despite the pain and symptoms.

Who Should Undergo and Expected Results

Paediatric pain management is intended for children and infants. Neonates are newly born babies while toddlers are between 1 and 3 years old and children are 12 years old and under. Teens, young adults, older adults, and seniors, meanwhile, are normally handled by internists. However, some families have their own physicians, in which case their family care doctors can treat a wide variety of diseases affecting members of varying ages.

Children who should be brought to a clinic or a hospital for paediatric pain management are those who are experiencing significant amount of pain that ultimately decreases the quality of their lives. Examples are those who are having difficulty walking, eating, standing, and sleeping. They may struggle with learning and develop mental confusion. These children may become socially withdrawn as they are having a hard time describing their own pain.

The pain may be brought by an acute (sudden) or chronic (long-term) health issue. For acute pain, it may be brought about by a sudden illness or trauma like a fall or a vehicle accident. Chronic pain, on the other hand, is usually caused by a debilitating illness including fibromyalgia, a condition wherein the body develops several tender points (areas that are painful to touch). The patient may also experience severe fatigue that drastically limits movements and activities.

The patient may also develop chronic headache and abdominal pain normally due to an underlying disease such as infection or issues affecting the digestive system (examples: irritable bowel syndrome, Crohn’s disease, or ulcerative colitis). Cancer is also a growing source of pain among children as the cancer spreads to many parts of the body or as medications such as chemotherapy and radiotherapy are provided, in which case pain becomes a side effect. An injury may also lead to chronic pain.

Pain can be disturbing for children. It can easily disrupt their regular activities, hamper their learning process, and isolate them from other kids. Thus, the main goal of paediatric pain management is to restore normalcy, create balance, and help children cope with the pain while doing the things they love. Pain management doesn’t necessarily treat or cure the disease.

How Does the Procedure Work?

There are many approaches to managing a child’s pain. These include:

  • Medication – Usually, the first and common option is medication. When a child enters an emergency hospital, the initial course of action is to relieve the pain. Otherwise, it will get in the way of treatment and recovery. Medications may include nerve blockers, which are drugs that block the pain signals from travelling to and from the brain without hindering other nerve activity.

  • Therapy – This may refer to both physical and occupational therapy. Injuries, for example, can decrease mobility due to pain. However, as the muscles of the body are not moved or used, they can waste away, adding more complications to the health problem. To prevent this, therapies can also be included in the child’s management programme. The therapy can restore or modify activities and functions.

  • Counselling – Counselling is a very important part of a child’s pain management programme as many children don’t understand why they’re feeling it in the first place. The lack of proper understanding can prevent them from receiving the right treatment, communicating their feelings, and coping effectively with the symptom and even the disease. A psychologist, social worker, or psychiatrist who has experience and expertise in handling children is qualified to do this.

As to how health care professionals create the programme, it can differ. Normally it involves:

  • Evaluation – The child is admitted to the hospital for a proper and comprehensive assessment. Different specialists are expected to see the child and perform the evaluation. Depending on how many procedures are needed, the hospital may suggest an admission, especially if the pain management needed is urgent or critical.

  • Collaboration – All the specialists then collaborate and discuss the most effective paediatric management plan for the child. As a child’s needs can be different from the others, the programme must be individualised.

  • Testing – For the first few days of admission, the programme will tested to see the response of the child. Modifications will be carried out when and as needed. Outpatient – Once the progress is believed to be satisfactory, the child will be allowed to leave the hospital while the specialists are expected to regularly monitor the patient’s condition.

Possible Risks and Complications

The biggest risk of paediatric pain management is the fact that it might not work. Also, medications and therapies can have some side effects. However, as long as they’re performed by trained professionals and according to healthcare standards, the side effects should be minor.

References:

  • http://www.cincinnatichildrens.org/service/p/pain/default/
  • http://www.stanfordchildrens.org/en/service/pain-management/conditions?
  • http://www.ama-cmeonline.com/painmgmt/printversion/amapainmgmt_m6.pdf
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