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Pediatric Pain Assessment

Terri Mathew RN, BSN

Nurse Educator
Facts About Pediatric Pain Management
 Child may not always be
willing or able to
communicate that they
are in pain
 Remember to incorporate
 When assessing the
effect of pain
medications, remember
to consider the patient’s
normal routine. If it’s
naptime the child may not
arouse easily.
Facts About Pediatric Pain Management
 Always consider other
reasons for patient
discomfort besides pain.
Is child hungry, wet or
want their parents.
 Communicate at the
child’s level
 Changes in vital signs do
not occur with all children
who are experiencing
severe pain, and may
even sleep
Pain Assessment

 Pain assessment
should be appropriate
to the developmental
 Pain assessment is
considered the 5th vital
sign and should be
assessed at the same
time as temperature,
pulse, respiration and
Quest Principles of pain assessment

 Question the child

 Use pain rating scales
 Evaluate behavior and physiological changes
 Secure parent’s involvement
 Take cause of pain into account
 Take action and evaluate results
Pediatric Pain Assessment Tools
Wong-Baker Pain Scale

Explain that each face is for a person who feels happy because he has no
pain (hurt) or sad because he has some or a lot of pain.
Face 0 is very happy because he does not hurt at all.
Face 1 hurts just a little bit
Face 2 hurts a little more
Face 3 hurts even more
Face 4 hurts a whole lot
Face 5 hurts as much as you can imagine
Non-Verbal Pediatric Pain Scale (FLACC)- The provider will assess each
category and obtain a number which is the pain assessment score. Then
the provider uses the same scale for reassessment.
0-10 pain scale is utilized to assess children’s pain when
they know there numbers and can verbalize that the
higher the number the greater the pain.
How often should pediatric pain be assessed?
 Pain is assessed by the registered nurse upon first
patient encounter, every medication administration
or other therapy (before and after), as well as at the
change of shift and patient report of pain
 Assessment criteria include: The intensity, pain site,
quality or nature of the pain, patients goal for
management of pain (if old enough to understand)
 Unlicensed assistive personnel may obtain a pain
score from the patient, but then must report it
immediately to the registered nurse
All information retrieved from Mercy’s pain policy
Pain Management
 Patients who report pain will be reassessed as frequently
as appropriate to achieve the patient’s acceptable level
of pain relief. The following guideline may be used to
establish timeframes for reassessment:
 Every 15 -30 minutes for intravenous analgesics
 Within one hour following oral or IM analgesics
 Respiratory rate, sedation level, and pain level will be
recorded every 2 hours for the first 8 hours and then
every 4 hours and as needed for the duration of PCA
All information retrieved from Mercy’s pain policy