The Pain Problem
Reylon Meeks,
RN, MSN, EMT
Blank Children's Hospital
Des Moines, Iowa
Pain is the most common reason for medical appointments in the United States. Pain has been perceived as an indicator of a problem, and therefore, many individuals seek help when they have pain. There is an estimated $100 billion spent each year in health care costs and loss of productivity as a result of pain. There are approximately 21.6 million patients routinely taking prescription analgesics.
For the infant and child, the undertreatment of pain has resulted from misperceptions and inappropriate knowledge for a variety of reasons. Many individuals do not know the child’s capabilities for pain and a valid pain assessment has not always been available. Further, the safe implementation of treatments and interventions has been questionable, lacking research in this population. The existence of pain in the infant and young child population has been doubted to a greater degree than in the adult population.
The skill and accuracy of recognizing pain is a challenge for the healthcare provider. Changes in the bio-chemical, physiological and behavioral components of the infant and child have led to the health care professionals’ ability to meet the challenge. Certain obstacles continue to exist, mainly in the overabundance of pain measures for infants that have been developed, and the lack of reliability and validity of many of them.
Most research on pain indicators include measures of vital signs because data are readily available and easy to observe in the clinical setting. Changes in vital signs are difficult to interpret as they are influenced by non-noxious stimuli in the pre-term or ill infant/ child. Due to the lack of specificity and inconsistency, vital signs alone cannot determine the presence or absence of pain. In combination with other behavioral and contextual indicators, however, vital signs may add a good deal of information regarding the infant/ child response to pain.
The harmful effects of untreated, undertreated and unrelieved pain in infants and children continue to be studied and there is much yet to be learned. The prevention of acute pain and effective treatment of chronic and acute pain will reduce the morbidity associated with exposure to repetitive pain in the pediatric population. Blank Children’s Hospital is committed to working with the child and their family to achieve acceptable pain relief.
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