Pain Assessment and Pain Relief Methods for Children

At Colchester Hospital we use three tools to help us assess how much pain your child is experiencing. These should be available in your child’s folder at their bedside. If your child is able to understand, he or she will be asked to rate his or her pain by telling us which face or number represents the amount of pain experienced.

Visual Analogue Scale (VAS) self-report

A scale of 1-10 is used. 0 being no pain and 10 being the worst pain they have ever experienced.

You can help by helping your child to use the tools above.

We would also like your opinion on your child’s pain and the effect of any pain relief your child has been given.

The nurse caring for your child will ask you to assess your child’s pain on the 0-10 pain scale. It is important that you tell the nurse if you think your child is uncomfortable and if the pain relief medicine used has helped to ease the pain.

There are various risks and side effects associated with all medicines and procedures. You must always read the instructions given with the suggested medicine. If your child is having an operation, you will be informed of all the risks and side effects beforehand.

Often, more than one form of pain relief will be used to help your child because it can result in longer lasting and more effective pain relief.

Children experiencing moderate pain will normally be given medicines that can be taken by mouth or as a suppository (small bullet-shaped tablet which is inserted into the child’s bottom). Medicines used at this hospital include paracetamol, ibuprofen and oral morphine.

Paracetamol is usually the drug of choice for children experiencing mild pain.

Severe pain is treated using a strong medicine such as morphine, which can be administered by mouth or through a drip.

An epidural will be used to control the pain in some children, A tube is inserted into the spine by the anaesthetist in theatre when your child is asleep.

If your child is having surgery the anaesthetist may inject local anaesthetic near the operation site or into the wound when your child is asleep. This can provide local pain relief (near to the area involved) for several hours after the operation.

The following techniques used in conjunction with pain relief medication can help relieve your child’s pain.

• Deep breathing exercises. Ask your child to start breathing slowly and deeply in through the nose. Then ask him or her to breathe out through the mouth by imagining blowing out candles on a birthday cake. Keep encouraging your child to do this slow deep breathing.
• Using their imagination. Asking children to imagine something they enjoy can distract them effectively. Subjects could include their favourite sport, holiday or beach. They must choose.

Encourage them to take deep breaths and imagine their special place or doing their favourite thing. If they feel comfortable, they can close their eyes. Ask questions such as:

– what can you see?

– What can you hear?

– what can you smell?

– what position are you playing (sports)?

Distraction 

There are many things you can do with your child instead of thinking about what is happening to him or her. The hospital’s play specialists have some great books and toys you can use. 

You can: 

– look at a book like Where’s Wally?’ 

– read a story

– blow bubbles 

– sing a song 

– practice counting 

– watch a DVD.

Muscle relaxation

Exercises are best performed in a warm, quiet place with minimal distractions. While you do this exercise with your child, encourage him or her to breathe slowly and deeply to squeeze or tighten each muscle for five seconds. 

Ask him or her to do the following in turn (reminding your child to keep breathing slowly and deeply throughout): 

– wiggle his or her toes and push them down and arch his or her feet 

– squeeze his or her thigh muscle and then relax, and let his or her legs go floppy 

– squeeze his or her tummy muscles 

– lift up his or her shoulders and pull the shoulder blades together 

– make a fist with the right hand and then release. Then push down with the elbow 

– repeat with the left arm 

– move the head from side to side and back to front to stretch and tense the neck muscles 

– frown, then wrinkle the nose 

– finally, smile and ask him or her to clench his or her jaw tightly, then relax.

Please phone one of the numbers on the front of this leaflet if you have any further concerns or worries.

When you attend hospital you will be asked to confirm your first and last names, date of birth, postcode and NHS number, if you know it, and to let us know if you have any allergies.

To find out how to give us feedback on your visit or healthcare experience, please visit www.esneft.nhs.uk and search for ‘PALS’ or ‘Your views matter’, or speak to a member of staff on the ward or department you are in.