Taking Care of Pain While in the Hospital

At the Alberta Children's Hospital we are Committed to Comfort. This means that we will do our best to promote comfort by helping to lessen pain and anxiety. We will ask about pain on a regular basis and use both medicine and comfort measures to help reduce any pain.

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Comittiment to Comfort

What is Pain?

Acute pain is an unpleasant sensation that may occur because of an injury, surgery, or illness. Pain is one way our body alerts us to pay attention and seek help. Every person is unique and experiences pain in a different way. We know that you are the expert in how you are feeling and how you want to try to feel better.

Chronic pain is defined as pain that persists or recurs for more than 3 months and is associated with significant emotional distress and/or functional disability.

How is pain assessed?

Whether you have come to the hospital though the emergency department, for surgery, or to stay overnight in an inpatient unit, your child’s healthcare team will ask about your child’s pain on a regular basis. We also observe behavior, check any painful areas, and measure pulse, breathing rate, or blood pressure. The observations we use to assess pain are based on a person's age and/or developmental stage. As you know your child's feelings and behaviors best, parents can help by letting the healthcare team know how their child is feeling. Medicine and comfort measures will be used to help reduce any pain or discomfort your child may experience.

We often use pain scales to help understand how a person is feeling. By answering questions or choosing pictures, pain is scored, using a scale of 0-10:

  • A score of 0 means no pain
  • A score of 4-6 is moderate pain
  • A score or 7 or higher means more severe pain
There are even pain scales for young children and for children who do not communicate with words.

What can parents do to help relieve their child's pain?

Children may be fearful of new places, new people, and new experiences, especially when they feel sick. Parents play a very powerful role in how children experience pain. In general, the calmer a parent can be, the less worried their child will be. We know that fear and anxiety can make pain worse. For this reason, we can work together to create a comfort plan to help calm fears and ease worry together. Encourage your child to let you and the healthcare team know how they are feeling and what might be worrying them. Recognize what your child is doing well, such as telling you about their pain, holding still during a procedure, or being brave.

What can be done to help relieve pain for medical procedures and needles?

Many children and youth who come to the hospital often ask or worry about whether something 'will hurt'. Families may have questions and concerns about pain medications or wonder about the best way to support their child during a potentially painful test, procedure, or treatment. We hope that the following information will help you know what to expect and how you can work with your child’s healthcare team to reduce pain, fear, and the worry it creates.

People come to the hospital for many different reasons. Sometimes it is because of a painful condition while other times a patient may need to have a medical procedure performed. Here are the six Commitment to Comfort Practices that are used for every painful and distressing procedure. When used together they are even more effective in reducing pain, fear, and worry.

  • Make a Plan
  • Use Comfort Positions
  • Apply Numbing Cream
  • Breastfeed or Use Sucrose
  • Use Distraction
  • Use Positive Language

Download the Caregiver Guide to helping your child in hospital and the Comfort Care Plan to help your child chose the comfort strategies they want to use for a painful or worrisome procedure.

We have lots of other items on our comfort menu. Some of these items can be provided by your healthcare team and some can be provided by you. For example; the healthcare team can provide a warm blanket, an ice pack, or a splint to help keep an effected area of the body still while healing. Children’s items brought from home, like a favorite blanket or stuffie can also provide comfort. Most kids find that they do best when they have both comfort measures and medicine to help with any pain. Child Life Specialists help to prepare and support you and your child for procedures or tests. Our specialists provide play opportunities, distraction items, and programming to help normalize the hospital environment.

What is Pain?

When you come into the Emergency Department with pain, we can give liquid pain medicine by mouth (most people don't mind the taste) or by pill, if that is preferred. Sometimes pain medicine can even be given into the nose.

For children who have had surgery, their pain is managed by the Acute Pain Team and the surgeon. For many children, especially those going home the same day, oral medications such as acetaminophen (Tylenol ®) or ibuprofen (Advil ®) will be used to relieve their pain.

Children who need stronger medicine often receive morphine. This type of drug is called an opioid. The amount given is carefully calculated based on weight to ensure that it is safe. It can be given as a liquid or tablet every 4-6 hours or through an IV. When given, children are carefully monitored.

What can be done to help manage and treat complex/chronic pain?

Chronic pain negatively affects 15% – 40% of youth. This pain can impact many aspects of life including: school performance, social and physical well-being, and mental health. The Chronic Pain Clinic at ACH uses a treatment and management plan that addresses the whole child/adolescent. The biopsychosocial model of care works to improve functioning in physical, psychological, and social areas of life.

See the Alberta Children’s Hospital Complex Pain Clinic handout

Other Resources

To learn more about pain please contact child.life@ahs.ca. To access resources please see the Pediatric Pain Information Prescription or contact childhealthinfo@ahs.ca .

Current as of: April 1, 2021

Disclaimer

This material is designed for information purposes only. It should not be used in place of medical advice, instruction and/or treatment. If you have specific questions, please contact your doctor or appropriate health care professional.
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