Taking Action
Right from the start.
How can hospitals and individuals make a difference in limiting the extent of suffering from pain in children?
The International Association for the Study of Pain has suggested priorities for action on a global, national, institutional (local) and individual level.
Although most health care professionals and parents cannot implement changes on a global or national level, individuals can spearhead systematic change.
Suggested priorities for action in the Global Year against Children's Pain
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Extend educational opportunities for health care providers in under-resourced areas.
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Where pain relief is limited by drug availability, advocate for improved funding and for reduction of regulatory barriers.
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Where pain relief is limited by drug availability, advocate for improved funding and for reduction of regulatory barriers.
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Provide awards to local health care providers who make significant contributions to relief of children's pain.
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Encourage public education on pediatric pain.
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Challenge incorrect public information on pain treatment.
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Adopt policies and standards for pain prevention and relief.
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Make pain assessment and treatment protocols for best practice accessible to all.
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Provide distraction supplies (toys, music, videos) together with training in their use and all settings where children undergo painful procedures.
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Work toward the establishment of interdisciplinary acute and chronic pediatric pain services or access to specialist expertise within all acute medical care settings to provide direct services, expert consultation and education.
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Ensure regular, developmentally appropriate pain assessment.
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Ensure a quick response to reports of pain.
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Provide written and/or pictorial information about pain management to children and parents.
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Provide training for parents to show them how they can best support their child's pain relief.
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Consistently provide behavioral, cognitive, and physical interventions to help children cope with procedural pain.
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Minimize needle procedures (avoid or combine blood sampling whenever possible).
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Commit to the use of pain-free routes for giving medication.
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Whenever possible, administer topical anesthetics for intravenous placement or injection.
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According to a report of the Subcommittee on the Management of Pain Associated with Procedures in Children with Cancer guideline statement, "The ideal goal of pain management for pediatric procedures is to make the procedure comfortable for the child and his or her parents. Success will be manifested by the child who is not afraid of subsequent procedures and not merely by a child who can be held still for procedures."10
The guideline makes specific recommendations for pain related to needle procedures including IV starts:
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Consolidating blood drawing using an indwelling catheter when possible
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When attempting IV access, use local anesthetics or saline intradermally for analgesia
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Children older than 2 years should be told what will be done and distraction methods should be used during the procedure