Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Dec;24(8):509-535.
doi: 10.1093/pch/pxz026. Epub 2019 Dec 9.

Managing pain and distress in children undergoing brief diagnostic and therapeutic procedures

[Article in English, French]
Evelyne D Trottier  1 , Marie-Joëlle Doré-Bergeron  1 , Laurel Chauvin-Kimoff  1 , Krista Baerg  1 , Samina Ali  1
Affiliations
Review

Managing pain and distress in children undergoing brief diagnostic and therapeutic procedures

[Article in English, French]
Evelyne D Trottier et al. Paediatr Child Health. 2019 Dec.

Abstract

Common medical procedures to assess and treat patients can cause significant pain and distress. Clinicians should have a basic approach for minimizing pain and distress in children, particularly for frequently used diagnostic and therapeutic procedures. This statement focuses on infants (excluding care provided in the NICU), children, and youth who are undergoing common, minor but painful medical procedures. Simple, evidence-based strategies for managing pain and distress are reviewed, with guidance for integrating them into clinical practice as an essential part of health care. Health professionals are encouraged to use minimally invasive approaches and, when painful procedures are unavoidable, to combine simple pain and distress-minimizing strategies to improve the patient, parent, and health care provider experience. Health administrators are encouraged to create institutional policies, improve education and access to guidelines, create child- and youth-friendly environments, ensure availability of appropriate staff, equipment and pharmacological agents, and perform quality audits to ensure pain management is optimal.

Keywords: Distress; Paediatrics; Pain; Procedures; Treatment.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Sitting position on caregiver’s lap; child facing the phlebotomist.
Figure 2.
Figure 2.
Sitting position on caregiver’s lap; child facing parent.
Figure 3.
Figure 3.
Sucrose administration.
Figure 4.
Figure 4.
Kangaroo care.
Figure 5.
Figure 5.
Swaddling.
Figure 6.
Figure 6.
Distraction.
Figure 7.
Figure 7.
Overhead ‘seek and find’ posters.
Figure 8.
Figure 8.
Blowing bubbles.
Figure 9.
Figure 9.
Cream application.
Figure 10.
Figure 10.
Distraction and nitrous oxide.
Figure 11.
Figure 11.
Nitrous oxide administration.
Figure 12.
Figure 12.
IN fentanyl using atomizer.
See this image and copyright information in PMC

References

    1. Fein JA, Zempsky WT, Cravero JP; Committee on Pediatric Emergency Medicine and Section on Anesthesiology and Pain Medicine; American Academy of Pediatrics Relief of pain and anxiety in pediatric patients in emergency medical systems. Pediatrics 2012;130(5):e1391–405. - PubMed
    1. Stevens BJ, Abbott LK, Yamada J, et al. ; CIHR Team in Children’s Pain. Epidemiology and management of painful procedures in children in Canadian hospitals. CMAJ 2011;183(7):E403–10. - PMC - PubMed
    1. Friedrichsdorf SJ, Postier A, Eull D, et al. Pain outcomes in a US children’s hospital: A prospective cross-sectional survey. Hosp Pediatr 2015;5(1):18–26. - PubMed
    1. Young KD. Pediatric procedural pain. Ann Emerg Med 2005;45(2):160–71. - PubMed
    1. Ali S, McGrath T, Drendel AL. An evidence-based approach to minimizing acute procedural pain in the emergency department and beyond. Pediatr Emerg Care 2016;32(1):36–42; quiz 43–4. - PubMed