Pain Assessment and Management in Children:

Question 1

Myths about Pain in Children:

Answer 1

• Pain cannot be assessed accurately in infants/children
• Children will tell you when they are in pain
• Infants/small children do not remember pain
• If a child can be distracted, they are not really in pain

Question 2

Assessment of Acute Pain:

Answer 2

• Three types of measures are used to measure the domain of pain intensity
  — Behavioral measures: crying, etc.
  — Physiologic measures: increased BP/ HR
  — Self-reporting/Parental Report
• Proper Pain Rating Scale is imperative to treat pain effectively!
  — Rate pain before treating it

Question 3

Faces pain scale:
- age?

Answer 3

Ages: 3-4)
Cant use below 3

Question 4

Numeric scale age

Answer 4

8 & >

Question 5

FLACC Scale

Answer 5

• for non verbal patients
• Graded out of 10: #/10

Question 6

Young Infant’s Response to pain:

Answer 6

• Generalized response of rigidity and thrashing
• Loud crying
• Facial expressions of pain (grimacing)
• No understanding of relationship between stimuli and subsequent pain

Question 7

Older Infant’s Response to Pain

Answer 7

• Withdrawal from painful stimuli
• Loud crying
• Facial grimacing
• *Physical resistance

Question 8

Child’s Response to Pain:
Young

Answer 8

• Loud crying and screaming
• *Verbalizations: ow!, Ouch!, It hurts!
• Thrashing limbs
• *Attempts to push away the stimulus

Question 9

Child’s Response to Pain:
School age child:

Answer 9

• Stalling behavior (wait a minute)
• Muscle rigidity
• May use all the behaviors of a young child

Question 10

Adolescent response to pain:

Answer 10

• Less vocal protest; less motor activity
• Increased muscle tension and body control
• More verbalizations (“It hurts”; “You’re hurting me”)