Pain Management and Awareness at Nicklaus Children's Hospital

Pain affects more Americans than the combined number of individuals with diabetes, heart disease and cancer.

How many people do you know who have pain?

Comparison of Pain with other leading illnesses:

  1. Estimated incidence of American adults with pain: More than 100 million Americans.
  2. Estimated incidence of American adults with diabetes:  26 million
  3. Estimated incidence of American adults with heart disease: nearly 17 million
  4. Estimated incidence of Americans with cancer: 13 million
 
*Data from the American Academy of Pain Medicine
 
 

Children experience pain from many causes.

The types of pain can be separated into the following:
  1. Everyday pain, such as skin scrapes and contusions, provide an opportunity for children to learn how to cope with pain.
  2. Short-term pain, such as ear infections or immunizations, are reported as more painful by younger children than older children.
  3. Recurrent pain, arises from many factors.  Examples including stomachaches, headaches, and leg and back pain are reported to occur in up to 30 percent of children.  There are two challenges with this type of pain: 
    1. This type of pain may come and go unexpectedly.
    2. It is sometimes difficult to find the cause of this pain.
  4. Disease-related and chronic pain may be a symptom of an underlying problem or may occur secondary to the effects of the disease and/or treatment.

 

Pain assessment tools are available to evaluate pain in all ages of children.

These tools are specific to the child’s age and developmental level and include the child’s self-report of pain, the observations of behaviors that may indicate pain and monitoring for physical changes that may indicate pain.  Routine use of these pain assessment tools help healthcare providers more effectively identify and treat pain
 

However, in children who are non-verbal or cognitively impaired, pain may be difficult to identify.  In a new program called Hand In Hand Together We Can, we partner with parents and caregivers by asking about specific pain behaviors that their child may demonstrate when they are experiencing pain.  This information allows us to more efficiently identify and treat pain
 

Nicklaus Children’s Hospital has many resources to help decrease children’s pain.

These resources include the following: 

  1. Besides the healthcare team, other departments that also have an active role in decreasing pain include Patient Guest Relations, Physical and Occupational Therapy, Behavioral Medicine and the Pain Management Service.
  2. To help promote comfort and decrease pain through developmentally appropriate distraction and play, resources include Child Life, music therapy, Bedside Buddies, Red Nose Clown Docs, and Pet Therapy are available.  
  3. Additionally activities outside of the room to places such as the Michael Fux Family Center, playroom and play spaces, Radio Lollipop, and special recreational experiences in the lobbies or amphitheater promote comfort and distraction from pain.

 

Children may use coping skills to deal with pain.

Two of the most common coping skills they use are play (distraction) and sleep.  Examples of other coping skills that children may use include listening to music, playing videogames, relaxation, breathing techniques and guided imagery. 
 

Many factors can affect your child’s pain.

The six most significant factors are:  
  1. Age and developmental level
  2. Associated symptoms such as nausea or anxiety
  3. Beliefs about the cause of the pain
  4. Ability to cope with the pain
  5. Previous experiences with pain 
  6. Observations of how others deal with pain
 

Most pain can be prevented, treated or at least reduced using a multimodal approach.

A multimodal approach includes a combination of physical techniques (such as positioning), psychological techniques (such as deep breathing) and pharmacological techniques (including various types of medications). 
 

Pain is dynamic and constantly changing.

Sometimes levels of pain can change as quickly as the lights changing on a traffic light.

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