Emergency Department Pain Management of Acute Abdominal Pain and Acute Appendicitis in Children.
A cute pain is a common presenting symptom in the pediatric emergency department (ED) This adverse stimulus occurs as a result of injury and illness. If a child's pain is not treated quickly and effectively, it can have long term physical and psychological sequelae [1 3] These long term consequences may include anticipatory anxiety during future procedures, a lowering of the pain threshold and sensitization to future pain, reduced effectiveness of analgesics, and increased analgesic requirements [1 3] Pain assessment Pain assessment is an important part of pain management, and ongoing assessment of the child's pain in the ED is essential. Because pain is a subjective experience, individual self reporting is the preferred method for assessing pain. However, in non verbal children, observational and behavioral assessment tools are acceptable alternatives when a valid self report is not available [3] Five instruments are commonly used to assess pain in the 0 18 year old age group: The Alder Hey Triage Pain scale (AHTPS) [Table 1] and the Face, Legs, Activity, Cry, Consolability scale (FLACC) [Table 2] are observational scoring tools designed for use in children aged 0 2 years The Faces Pain Rating scale (FPR) [Figure 1] and the Visual Analog Scale (VAS) [Figure 2] are self report scoring scales designed for use in children aged 3 7 years and 8 15 years, respectively. Similar to adults, the self report verbal numeric rating scale is used in children aged 16 18 years [3,4]
The Israel Medical Association journal IMAJ