Assessing pain in children

Acute pain is one of the most common experiences a child will have as a result of injury, illness or medical procedures. It is associated with anxiety, fear, stress and distress. Despite this, acute pain in a child is often inadequately assessed, managed and treated. The paediatric experience of acute pain involves the interaction of physiological, psychological, behavioural, developmental and situational factors. The subjectivity and multidimensional nature of pain requires clinicians to approach pain assessment using a combination of a child’s verbal report in conjunction with behavioural observation and physiological measures. Recognizing, treating and reassessing are essential components of acute pain assessment. Wherever possible a proactive approach should be adopted, where pain assessment is integrated into the holistic admission procedure rather than performed in isolation when the child is in pain. To provide effective pain management in children, healthcare professionals should use age and developmentally appropriate pain assessment tools, anticipate painful experiences and intervene accordingly. This article describes pain assessment tools for the management of acute pain in infants and children (excluding neonates).