scholarly journals Canadian Emergency Medicine Residents’ Perspectives on Pediatric Pain Management

CJEM ◽  
2015 ◽  
Vol 17 (5) ◽  
pp. 507-515 ◽  
Author(s):  
Huma Ali ◽  
Janeva Kircher ◽  
Christine Meyers ◽  
Joseph MacLellan ◽  
Samina Ali
Keyword(s):  
Emergency Medicine ◽  
Pain Management ◽  
Online Survey ◽  
Oral Morphine ◽  
Management Approach ◽  
Developmentally Delayed ◽  
Pediatric Pain ◽  
Graduate Curricula ◽  
Facilitators And Barriers ◽  
Children's Pain

AbstractBackgroundUnder-treatment of children’s pain in the emergency department (ED) can have many detrimental effects. Emergency medicine (EM) residents often manage pediatric pain, but their educational needs and perspectives have not been studied.MethodsA novel online survey was administered from May to June 2013 to 122 EM residents at three Canadian universities using a modified Dillman methodology. The survey instrument captured information on training received in pediatric acute pain management, approach to common painful presentations, level of comfort, perceived facilitators, and barriers and attitudes towards pediatric pain.Results56 residents participated (46%), 25 of whom (45%) indicated they had not received any training in pediatric pain assessment. All levels of residents reported they were uncomfortable with pain assessment in 0-2 year olds (p=0.07); level of comfort with assessment increased with years of training for patients aged 2-12 years (p=0.02). When assessing children with disabilities, 83% of respondents (45/54) indicated they were ‘extremely’ or ‘somewhat’ uncomfortable. Sixty-nine percent (38/55) had received training on how to treat pediatric pain. All residents reported they were more comfortable using pain medication for a 9 year old, as compared to a 1 year old (oral oxycodone p<0.001, oral morphine p<0.001, IV morphine p=0.004). The preferred methods to learn about children’s pain management were role-modeling (61%) and lectures (57%). The top challenges in pain management were with non-verbal, younger, or developmentally delayed patients.ConclusionCanadian EM residents report receiving inadequate training in pediatric pain management, and are particularly uneasy with younger or developmentally disabled children. Post-graduate curricula should be adjusted to correct these self-identified weaknesses in children’s pain management.

Dynamics on the field: A focused ethnographic study of pediatric pain management at four Ghanaian hospitals

2020 ◽  
Author(s):  
Abigail Kusi Amponsah ◽  
Evans Oduro ◽  
Victoria Bam ◽  
Joana Kyei-Dompim ◽  
Collins Kwadwo Ahoto ◽  
...  
Keyword(s):  
Pain Management ◽  
Pain Assessment ◽  
Management Practices ◽  
Participant Observation ◽  
Symbolic Capital ◽  
Ethnographic Study ◽  
Pediatric Care ◽  
Pediatric Pain ◽  
Improvement Programs ◽  
Children's Pain

Abstract BackgroundAs part of efforts to develop and implement a short course educational program on pediatric pain management, the current study sought to understand the culture and contextual factors that influence children’s pain management in order to improve the practice in pediatric care settings.MethodsGuided by Bourdieu’s theory of practice, a focused ethnographic study was conducted from October, 2018 to February, 2019. The study was contextualized at four Ghanaian hospitals among purposefully sampled nurses, physicians, hospitalized children and their families. During the 20-week study period, three ethnographers spent 144 hours conducting participant-observation sessions. Formal and informal interviews were held with participants in addition to review of hospital records. Results Analysis of the field data resulted in four themes. “Children’s pain expression and response of caregivers” described the disposition (habitus) of both children and caregivers to act in particular ways due to children’s incomplete health status (bodily capital) which caused them pain and also resulted in discomforting procedures. “Pharmacological pain management practices and attitudes” elucidated the use of analgesics as the mainstay disposition (habitus) in children’s pain management due to high level of respect (symbolic capital) given to such interventions on the pediatric units (field). “Managing pain without drugs” illustrated healthcare providers and family caregivers’ disposition (habitus) of using diverse nonpharmacological methods in managing children’s pain. “Communication and interaction between pain actors” depicted how children’s access to care givers (social capital) can serve as a powerful tool in influencing pediatric pain assessment and management disposition (habitus) on the pediatric units (field). ConclusionsThe habitus of pediatric pain actors toward pain assessment and management practices are influenced by various forms of capital (social, cultural, symbolic, bodily and economic) operating at different levels on the pediatric care field. Quality improvement programs that seek to enhance pediatric pain management should use the insights obtained in this study to guide the development, implementation and evaluation stages.

scholarly journals The use of oral opioids to control children’s pain in the post-codeine era

2021 ◽  
Vol 26 (2) ◽  
pp. 120-123
Author(s):  
Michael J Rieder ◽  
Geert ’t Jong
Keyword(s):  
Pain Management ◽  
Severe Pain ◽  
Oral Morphine ◽  
Evidence Based ◽  
Efficacy And Safety ◽  
Limited Data ◽  
Safety And Efficacy ◽  
Safety Concerns ◽  
Analgesic Therapy ◽  
Children's Pain

Abstract Pain is a common problem for children, and pain management comprises both pharmacologic and nonpharmacologic measures. For moderate to severe pain, oral opioids have been a popular choice for the last few decades. Codeine has historically been the best-known oral opioid for use in children. However, availability and use of codeine have sharply declined due to safety concerns. A variety of other opioids have been used in place of codeine, but data are limited regarding their efficacy and safety in children. While the same pathways metabolize oral oxycodone as codeine, oxycodone’s pharmacokinetics varies widely. There are also limited data on the safety and efficacy of oral hydromorphone and tramadol use for children. Oral morphine is the opiate alternative to codeine for which there is the most evidence of safety and efficacy in children. Research is needed to investigate both other opioids and non-opioid approaches to guide evidence-based analgesic therapy and treatment for moderate-to-severe pain in children.

scholarly journals Assessment of Saudi Mothers’ Attitudes towards Their Children’s Pain and Its Management

2021 ◽  
Vol 18 (1) ◽  
pp. 348
Author(s):  
Sultan M. Alghadeer ◽  
Syed Wajid ◽  
Salmeen D. Babelghaith ◽  
Mohamed N. Al-Arifi
Keyword(s):  
Social Sciences ◽  
Pain Management ◽  
Healthcare Providers ◽  
Pediatric Pain ◽  
Cross Sectional ◽  
Web Based ◽  
Awareness Programs ◽  
Children's Pain ◽  
Arabic Speaking

Background and objective: Pain is a bothersome issue that is common among newborns and children of all ages. Pain can be managed using various pharmacological and/or non-pharmacological strategies, which can be delivered by healthcare providers or parents. The aim of this study is to assess the attitude of mothers toward their children’s pain and its management. Methods and materials: A descriptive cross-sectional web-based study was conducted using a developed self-reported questionnaire, from March 2018 to April 2018. Participants involved were Arabic-speaking mothers of children aged between 0 and 12. The data collected included pharmacological and non-pharmacological treatment methodologies utilized to treat pain and the mothers’ attitude towards pain management. Statistical Package for Social Sciences, version 25 was applied to analyze the data, and descriptive statistics were performed. Results: As per the results of this study, the most common site of children’s pain as reported by the mothers was mouth/throat (211; 52.9%), abdomen (199; 49.9%), followed by head (58; 14.5%), and finally, ears (69; 17.3%). The frequency of children’s pain, as stated by the mothers, was less than once a month (196; 49.1%), once in a month (137; 34.3%), and once in a week (48; 12%). The non-pharmacological methods used by mothers at home for the management of their children’s pain were as follows: letting them take rest or sleep (250; 62.6%), feeding them with fluids (228; 57.1%), applying cold packs (161; 40.4%), providing massage therapy (147; 36.8%), using warm packs (141; 35.3%), and taking them to play (119; 29.8%). Conclusion: The misconceptions about pediatric pain management among Saudi mothers that can affect the children’s quality of life are quite noticeable. Implementing educational and awareness programs about the management of child pain could play a major role in making the parents understand the impacts of their misconceptions.

scholarly journals Dynamics on the field: a focused study on the culture and context of pediatric pain management at four Ghanaian hospitals

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Abigail Kusi Amponsah ◽  
Evans Oduro ◽  
Victoria Bam ◽  
Joana Kyei-Dompim ◽  
Collins Kwadwo Ahoto ◽  
...  
Keyword(s):  
Pain Management ◽  
Pain Assessment ◽  
Management Practices ◽  
Participant Observation ◽  
Symbolic Capital ◽  
Ethnographic Study ◽  
Pediatric Care ◽  
Pediatric Pain ◽  
Improvement Programs ◽  
Children's Pain

Abstract Background As part of efforts to develop and implement a short course educational program on pediatric pain management, the current study sought to understand the culture and contextual factors that influence children’s pain management in order to improve the practice in pediatric care settings. Methods Guided by Bourdieu’s theory of practice, a focused ethnographic study was conducted from October, 2018 to February, 2019. The study was contextualized at four Ghanaian hospitals among purposefully sampled nurses, physicians, hospitalized children and their families. During the 20-week study period, three ethnographers spent 144 h conducting participant-observation sessions. Formal and informal interviews were held with participants in addition to review of hospital records. Results Analysis of the field data resulted in four themes. “Children’s pain expression and response of caregivers” described the disposition (habitus) of both children and caregivers to act in particular ways due to children’s incomplete health status (bodily capital) which caused them pain and also resulted in discomforting procedures. “Pharmacological pain management practices and attitudes” elucidated the use of analgesics as the mainstay disposition (habitus) in children’s pain management due to high level of respect (symbolic capital) given to such interventions on the pediatric units (field). “Managing pain without drugs” illustrated healthcare providers and family caregivers’ disposition (habitus) of using diverse nonpharmacological methods in managing children’s pain. “Communication and interaction between pain actors” depicted how children’s access to care givers (social capital) can serve as a powerful tool in influencing pediatric pain assessment and management disposition (habitus) on the pediatric units (field). Conclusions The habitus of pediatric pain actors toward pain assessment and management practices are influenced by various forms of capital (social, cultural, symbolic, bodily and economic) operating at different levels on the pediatric care field. Quality improvement programs that seek to enhance pediatric pain management should use the insights obtained in this study to guide the development, implementation and evaluation stages.

Emergency Medical Services Provider Comfort with Prehospital Analgesia Administration to Children

2014 ◽  
Vol 30 (1) ◽  
pp. 66-71 ◽  
Author(s):  
Amaly Rahman ◽  
Sarah Curtis ◽  
Beth DeBruyne ◽  
Sunil Sookram ◽  
Denise Thomson ◽  
...  
Keyword(s):  
Pain Management ◽  
Emergency Medical Services ◽  
Medical Services ◽  
Clinical Judgement ◽  
Pediatric Pain ◽  
Emergency Medical ◽  
Emergency Medical Services Personnel ◽  
Pediatric Analgesia ◽  
Children's Pain ◽  
The City

AbstractIntroductionThe undertreatment of pediatric pain is a significant concern among families, clinicians, and researchers. Although some have examined prehospital pain management, the deterrents to pediatric analgesia administration by Emergency Medical Services (EMS) have not yet been examined in Canada.ProblemThis study describes EMS pain-management practices and prehospital provider comfort treating pediatric pain. It highlights differences in pain management between adults and children and assesses the potential barriers, misconceptions, difficulties, and needs related to provision of pediatric analgesia.MethodsA study-specific survey tool was created and distributed to all Primary Care Paramedics (PCPs) and Advanced Care Paramedics (ACPs) over four mandatory educational seminars in the city of Edmonton (Alberta, Canada) from September through December 2008.ResultsNinety-four percent (191/202) of EMS personnel for the city of Edmonton completed the survey. The majority of respondents were male (73%, 139/191), aged 26-35 (42%, 80/191), and had been in practice less than 10 years (53%, 101/191). Seventy-four percent (141/191) of those surveyed were ACPs, while 26% (50/191) were PCPs. Although the majority of respondents reported using both pain scales and clinical judgement to assess pain for adults (85%, 162/191) and adolescents (86%, 165/191), children were six times more likely than adults (31%, 59/191 vs 5%, 10/191) to be assessed by clinical judgement alone. Emergency Medical Services personnel felt more comfortable treating adults than children (P < .001), and they were less likely to treat children even if they were experiencing identical types and intensities of pain as adults (all P values <.05) and adolescents (all P values < .05). Twenty-five percent of providers (37/147) assumed pediatric patients required less analgesia due to immature nervous systems. Three major barriers to treating children's pain included limited clinical experience (34%, 37/110), difficulty in communication (24%, 26/110) and inability to assess children's pain accurately (21%, 23/110).ConclusionEmergency Medical Services personnel self-report that children's pain is less rigorously measured and treated than adults’ pain. Educational initiatives aimed at increasing clinical exposure to children, as well as further education regarding simple pain measurement tools for use in the field, may help to address identified barriers and discomfort with assessing and treating children.RahmanA, CurtisS, DeBruyneB, SookramS, ThomsonD, LutzS, AliS. Emergency Medical Services provider comfort with prehospital analgesia administration to children. Prehosp Disaster Med. 2015;30(1):1-6.

scholarly journals PEDIATRIC PROCEDURAL PAIN MANAGEMENT: A REVIEW OF THE LITERATURE

2012 ◽  
Vol 3 (4.1) ◽  
pp. 569 ◽  
Author(s):  
Kristy Petovello
Keyword(s):  
Health Care ◽  
Pain Management ◽  
Health Care Professionals ◽  
Complex Nature ◽  
Pediatric Pain ◽  
Health Seeking ◽  
Health Care Experiences ◽  
Values And Beliefs ◽  
Early Health ◽  
Children's Pain

<p>Research in the last two decades has revealed the complex nature of pain and has thereby improved the understanding, treatment, and management of pediatric pain by health care practitioners. However, a significant gap between knowledge and practice still exists. Pediatric pain remains under-managed. Several themes emerged in this literature review as factors influencing adequate pain management. These include: outdated beliefs about pain management; inconsistent use of evidence-based interventions; difficulties assessing children’s pain; and the role of the values and beliefs of caregivers and practitioners. The literature indicates a high risk of deleterious consequences of under-managed pediatric pain, linking early health care experiences to later health-seeking behaviours. Implications for practice are considerable. Recommendations include: an individualized “3-P” approach combining pharmacologic, physical and psychological strategies; collaborative approaches eliciting expertise from caregivers and health care professionals across multiple disciplines; and utilizing interventions before, during, and after procedures. <strong></strong></p>

scholarly journals 191: Pediatric Pain Management: the Emergency Medicine Residents' Perspectives

2014 ◽  
Vol 19 (6) ◽  
pp. e100-e101
Author(s):  
H Ali ◽  
C Meyers ◽  
J Kircher ◽  
J MacLellan ◽  
S Ali
Keyword(s):  
Emergency Medicine ◽  
Pain Management ◽  
Pediatric Pain

scholarly journals Final Year Nursing Students’ Knowledge and Attitudes regarding Children’s Pain

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Abigail Kusi Amponsah ◽  
Joana Kyei-Dompim ◽  
Evans Frimpong Kyei ◽  
Evans Oduro ◽  
Richard Adongo Afaya ◽  
...  
Keyword(s):  
Pain Management ◽  
Nursing Students ◽  
Financial Burden ◽  
Well Being ◽  
Educational Interventions ◽  
Pediatric Pain ◽  
Knowledge And Attitudes ◽  
Management Interventions ◽  
Pain Knowledge ◽  
Children's Pain

Pain is one of the commonest reasons why children visit the hospital. Inadequately treated pain in children can negatively affect their physical, psychological, and social well-being; it also places financial burden on families of affected children and healthcare systems in general. Considering the eventual suffering of vulnerable children and their families if nursing students are insufficiently educated and ill-prepared, the current study aimed at assessing final year nursing student’s knowledge and attitudes pertaining to pediatric pain. A descriptive cross-sectional study was conducted among 100 final year undergraduate nursing students at a private university college in Ghana. In addition to their ages and gender, the students responded to the 42 individual items on the Pediatric Nurses’ Knowledge and Attitudes Survey regarding pain (PNKAS) instrument. Descriptive statistical analysis was aided by the Statistical Package for Social Sciences version 25 software. The mean age of the final year nursing students was 29 years (range of 21 to 47 years); a majority of them were females (78%). Participants had an average (SD) correct answer score of 44.0% (10.6%). Good pediatric pain knowledge and attitudes were observed in items that were related to the individualized and multidimensional nature of the pain experience and its treatment, benefits of pre-emptive analgesia, pharmacodynamics, and pain assessment. Poor pediatric pain knowledge and attitudes occurred in items that focused on pain perceptions, opioid drug administration, useful pain medications, pain physiology, and nonpharmacological pain management interventions. Final year nursing students have insufficient knowledge and attitudes toward children’s pain management. Areas of good and poor pediatric pain knowledge and attitudes should be considered when designing and implementing educational interventions on this subject. Curricular revisions should be made on existing nursing curriculum to lay more emphasis on children’s pain management and use educational interventions that support knowledge translation for improved care.

Recent concepts in understanding a child's pain

1991 ◽  
Vol 81 (5) ◽  
pp. 231-242 ◽  
Author(s):  
KT Mahan ◽  
DC Strelecky
Keyword(s):  
Pain Management ◽  
Pain Assessment ◽  
Psychological Aspects ◽  
Pediatric Pain ◽  
Complex Process ◽  
Assessment Techniques ◽  
Children's Pain

The management of pain in children is a complex process that has significant differences from adult pain management. The authors describe the myth of children's lack of pain and how that myth has resulted in frequent undermedication of children's pain. The authors describe the physical and psychological aspects of pain. Assessment techniques for more accurately determining pain in children are also described. The authors conclude with a description of pharmacologic aspects of pediatric pain management.

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