We do everything in our power to ensure that your child's stay is as pain-free as possible. However, it is inevitable that some procedures will cause discomfort. This can be a frightening experience for many children, and for this reason, Children's Hospital is committed to making pain assessment and management a priority for your child.
While at Children's, your child will be cared for by a highly-skilled, multidisciplinary team of health care professionals dedicated to helping him/her get better in the most pain-free way possible. If your child experiences pain, our team can help relieve their discomfort through a variety of methods, including:
- Physician-prescribed pain relief medication
- Changes in treatment plan
- Providing comfort measures
- Education for you and your child on ways to decrease and control pain
- Environmental changes, such as reducing room noise level and lighting, using pillows to support painful areas, and frequent position changes in bed
- Play therapy
- Distraction techniques such as breathing exercises, music, talking with your child, watching TV, reading books, and playing video games, which help to divert a child's attention from their pain
- Combinations of mind and body activities that alter or suppress painful sensations, such as deep breathing exercises, muscle relaxation, guided imagery, and behavioral modification
- Patient-controlled analgesia (PCA), which allows the patient to control the delivery of pain medication given intravenously using a special infusion device. The infusion device has built in safety features to prevent a child from receiving too much medication
- Epidural analgesia, which involves a small plastic catheter that is placed in your child's back while he/she is sedated or under general anesthesia. Pain medications can be given through this catheter for several days and it is an effective approach to managing severe pain
- Nerve blocks
- Applying heat, cold, splints, exercise, hydrotherapy, and transcutaneous electrical nerve stimulation (TENS), in which a mild electrical stimulation is delivered through the skin by electrodes placed over the painful area
- Reiki - A hands-on touch therapy which restores energy balance promoting reduction of stress, anxiety, nervousness, pain or discomfort
- Spiritual support and counseling to help cope with the pain
Assessment of your child's pain is very important so that the nurses and doctors can more effectively treat them. Pain that goes untreated can interfere with your child's sleep, eating, and play schedule. Children's Hospital uses several methods to determining the level of your child's pain, methods that parents can also use at home.
What a Child Says
The best way to know if your child is hurting is to ask. Only your child knows how they feel. Even kids as young as three or four-years-old can tell us how much they are hurting.
The Hospital uses pain assessment tools as a way of rating how much pain a child is feeling so our medical and nursing staff can administer the appropriate treatment. Examples of these assessment tools include the Faces Scale, which shows a series of faces from happy (no pain) to very upset (the worst possible pain). If this tool is used, your child will be asked to choose the face that matches how they feel.
Another pain assessment tool is the Number Scale, in which a child rates his/her amount of pain from 0 (no pain) to 10 (worst pain).
Along with these assessment tools, your child may also be asked to respond to questions such as: "Where does it hurt? Can you describe your pain? What makes the pain better or worse?"
How a Child Acts
Changes in a child's behavior can also be important clues in the presence of pain, especially in babies and young children who can't tell us exactly where they hurt or describe the way they feel. Behaviors such as crying, changes in facial expression, holding or rubbing where it hurts, being less active than normal, and not eating or sleeping can all be important clues to your child's pain.
The Hospital uses behavioral pain rating scales for infants and young children who are not verbal.
It is also important to remember that a child can have pain and not show it. Play is one of the ways that a child copes with pain, and children may sleep because they are tired from the pain.
How the Child's Body is Reacting
Pain can change a child's heart rate, blood pressure, breathing, level of oxygen, skin color, temperature, and sweating. These changes usually don't last long, even if the pain persists. They can also be caused anxiety, hunger, or because of your child's medical condition.
Pain Medicines vs. Substance Abuse
Many parents worry that their child will develop an addiction to their pain medication and continue to need the drug for psychological effects and not for medical reasons. These worries are unfounded, as numerous studies show that children will take less pain medicine as pain decreases, and eventually stop taking the medicine as pain ceases.
Pain Management Care Team
When assessing and treating your child's pain, specialists from throughout the Hospital work together to ensure a comfortable stay for him/her. Children's doctors, nurses, child life specialists, psychologists, pain service personnel, rehab/physical therapists, and even our chaplains help control your child's pain.
But it's not just hospital staff who play a part in pain management. Parents are also very important because they're experts when it comes to their child's pain. If you know that your child is in pain, it is essential that you tell the nurse or doctor right away. Parents should always consider themselves part of their child's "health care team", but especially so when it comes to pain management.
Remember, when your child must have a procedure that is painful, tell them the truth about what will happen and what it will feel like. How you react can and usually will affect how your child will respond.