The purpose of this book is to emphasize the importance of recognizing, assessing and treating pain in children. Parents, children, family members and health care providers can effectively identify types of pain and pain levels in various situations by asking the necessary questions a... nd using appropriate pain scales. Pain scales are also available for those who are unable to self-report pain, which are not included in this book. Parents and family members have the unique opportunity to understand the specific behaviors or expressions that may indicate that a child is in pain. The most reliable information is whatever the child says about their pain. "The mainstay of pain assessment is the patient self report." (Jacox, 1994, p. 3). Healthcare providers and educators can reinforce the importance of accurate pain assessment in the pediatric population. Assessment of pain is now the 5th vital sign, along with temperature, pulse, respiration and blood pressure. Since the pain experience is unique to each individual, it is important to encourage the child to freely express what they are feeling as well as description of their pain. Schechter, Berde, and Yaster, (2003) describe that in the past, very little information was available regarding the treatment of pain in children. Unfortunately, this often resulted in inadequate pain management for children. Many myths were widely accepted that children did not experience pain in the same way as adults. It was thought that children were better able to tolerate pain and they did not remember painful experiences. It was also accepted that the nervous system was underdeveloped so children were not able to perceive or experience pain. According to Weisman, Bernstein, Schechter, 1998 (as cited in Schechter, Berde, and Yaster, 2003) more recent study has this been shown to be incorrect. There may be consequences for not treating pain effectively. "Children who are subjected to painful procedures without analgesia develop increased anxiety about the next procedure and will often experience pain despite adequate analgesia compared with a group who had adequate pain control initially. Their anxiety about upcoming procedures may be so overwhelming that it can dominate and color their relationship with their health care providers and even with their parents." (Schechter, Berde, and Yaster, 2003, p. 14). This book focuses on a child's experience with an abrupt onset of pain resulting in evaluation in the emergency department, admission to hospital, surgery, recovery and discharge to home. Each step in this process provides the opportunity to carefully assess and manage pain effectively.
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