Managing pain and distress in children undergoing brief diagnostic and therapeutic procedures

Abstract

Common medical procedures to assess and treat patients can cause significant pain and distress. Clinicians should have a basic approach for minimizing pain and distress in children, particularly for frequently used diagnostic and therapeutic procedures. This statement focuses on infants (excluding care provided in the NICU), children, and youth who are undergoing common, minor but painful medical procedures. Simple, evidence-based strategies for managing pain and distress are reviewed, with guidance for integrating them into clinical practice as an essential part of health care. Health professionals are encouraged to use minimally invasive approaches and, when painful procedures are unavoidable, to combine simple pain and distress-minimizing strategies to improve the patient, parent, and health care provider experience. Health administrators are encouraged to create institutional policies, improve education and access to guidelines, create child- and youth-friendly environments, ensure availability of appropriate staff, equipment and pharmacological agents, and perform quality audits to ensure pain management is optimal.

Interventions to Improve the Cast Removal Experience for Children and Their Families: A Scoping Review

“…Accordingly, recommendations have been developed to help parents and health care providers prevent or reduce a child’s experience of pain or distress during specific types of painful or invasive health care procedures and in primary care settings [ 6 , 7 ]. One approach to framing recommendations is the “3P’s” approach, which categorizes strategies to prevent or reduce pain or distress during medical procedures as physical, psychological or pharmacologic [ 8 , 9 ]. Examples of physical approaches include infant or child positioning, and parent presence or participation during the procedure [ 8 ].…”

“…One approach to framing recommendations is the “3P’s” approach, which categorizes strategies to prevent or reduce pain or distress during medical procedures as physical, psychological or pharmacologic [ 8 , 9 ]. Examples of physical approaches include infant or child positioning, and parent presence or participation during the procedure [ 8 ]. Psychological techniques can include relaxation, preparatory strategies, or distraction [ 8 , 9 ].…”

“…Examples of physical approaches include infant or child positioning, and parent presence or participation during the procedure [ 8 ]. Psychological techniques can include relaxation, preparatory strategies, or distraction [ 8 , 9 ]. Pharmacologic approaches may include a topical anesthetic or mild sedation [ 8 ].…”

“…Psychological techniques can include relaxation, preparatory strategies, or distraction [ 8 , 9 ]. Pharmacologic approaches may include a topical anesthetic or mild sedation [ 8 ]. Tailoring the approaches to the age of the child, as well as the procedure are important, and guidance documents have provided clear recommendations for procedures such as needle pokes, laceration repair, and surgery [ 8 , 9 ].…”

Using AI-Enhanced Social Robots to Improve Children’s Healthcare Experiences

“…Children experience pain and distress in clinical settings every day, with the negative consequences of unaddressed pain producing both short-term (e.g., fear, distress, inability to perform procedures) and long-term (e.g., needle phobia, anxiety) effects [15,24]. A range of psychological interventions have been clinically demonstrated to be effective for managing procedural pain, including breathing exercises, child-directed distraction, nurse-led distraction, and combined cognitive-behavioural interactions [5], with these interventions successfully delivered through a variety of mechanisms including bubble machines, distraction cards, kaleidoscopes, music therapy, and virtual reality games [29].…”