Nonpharmacologic Pain Management Strategies in the Pediatric Emergency Department

Youth often arrive in the emergency department (ED) in a state of emotional and physical distress. This distress is exacerbated by unfamiliar environmental stimuli, perceived threat of procedures, and general discomfort inherent in many medical procedures. Pain itself is a highly individualized experience that is most effectively treated via a multimodal, multisystem approach. For this reason, it is imperative that nonpharmacologic pain and stress management strategies are a part of standard ED protocol. Cognitive-behavioral interventions aim to reduce fear, minimize distress and pain, and increase a child's and parents' sense of control. Emergency department staff should be trained on ways to prepare a child for a procedure. After preparation, youth can benefit from being offered brief training in coping strategies. Upon discharge, families should be equipped to continue implementing these newly learned skills at home and during future hospitalizations. This article offers the reader specific strategies to use with youth presenting to an ED.