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Review
. 2022 Dec 9;27(7):429-448.
doi: 10.1093/pch/pxac048. eCollection 2022 Dec.

Best practices in pain assessment and management for children

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

Best practices in pain assessment and management for children

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

Abstract

Pain assessment and management are essential components of paediatric care. Developmentally appropriate pain assessment is an important first step in optimizing pain management. Self-reported pain should be prioritized. Alternatively, developmentally appropriate behavioural tools should be used. Acute pain management and prevention guidelines and strategies that combine physical, psychological, and pharmacological approaches should be accessible in all health care settings. Chronic pain is best managed using combined treatment modalities and counselling, with the primary goal of attaining functional improvement. The planning and implementation of pain management strategies for children should always be personalized and family-centred.

Keywords: Analgesia; Assessment; Paediatrics; Pain; Treatment.

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Figures

Figure 1.
Figure 1.
Faces pain scale–revised. Note: Consult the International Association for the Study of Pain (IASP) website for details. www.iasp-pain.org/Education/Content.aspx?ItemNumber=1519
Figure 2.
Figure 2.
FLACC and r-FLACC scales. Adapted from Malviya 2006 (30) combining the original FLACC (text in bold) and the addition of the r-FLACC (text in italic)
Figure 3.
Figure 3.
EVENDOL scale. Instructions: 1Assess at rest (R): observe the child from a distance, before performing any examination or procedure, at rest, ensuring the best possible conditions of safety and comfort, for example, with his/her parents, when he/she is playing. 2During examination or mobilization (M): assess pain during examination or mobilization or palpation of the painful area by nurse or by doctor. 3Reassess pain regularly after analgesic administration: wait 30 to 45 min if analgesic is administered by oral or rectal route, 5 to 10 min if administered by IV route. Note whether the child is at rest (R) or mobilized (M). From reference 31. Reproduced with permission.
See this image and copyright information in PMC

References

    1. Bulloch B, Garcia-Filion P, Notracia D, Bryson M, McConahay T.. Reliability of the color analog scale: Repeatability of scores in traumatic and nontraumatic injuries. Acad Emerg Med 2009;16(5):465–9. - PubMed
    1. Birnie KA, Chambers CT, Fernandez CV, et al. . Hospitalized children continue to report undertreated and preventable pain. Pain Res Manag 2014;19(4):198–204. - PMC - PubMed
    1. Paquin H, Trottier ED, Robitaille N, Pastore Y, Bergeron MJ, Bailey B.. Oral morphine protocol evaluation for the treatment of vaso-occlusive crisis in paediatric sickle cell patients. Paediatr Child Health 2019;24(1):e45–50. - PMC - PubMed
    1. Drendel AL, Kelly BT, Ali S.. Pain assessment for children: Overcoming challenges and optimizing care. Pediatr Emerg Care 2011;27(8):773–81. - PubMed
    1. Malviya S, Voepel-Lewis T, Merkel S, Tait AR.. Difficult pain assessment and lack of clinician knowledge are ongoing barriers to effective pain management in children with cognitive impairment. Acute Pain 2005;7(1):27–32.