[Analgesics in pediatrics. Before prescribing: recognize and evaluate pain, reassure].
CAREFUL ASSESSMENT: In pediatric clinics, it has become habitual to prescribe analgesics in all painful situations. Particular attention must be paid to pain experienced by the child and obtaining objective evidence allowing valid assessment prior to treatment. ACUTE PAIN: Usually clearly expressed by crying screams, agitation, retraction and protection of the painful area, signs of acute pain are nonspecific and not proportional to its intensity. PROLONGED PAIN: Sadness and depression confound the expression of prolonged pain. Diagnosis may be difficult; an association between a potentially painful situation, pain relieving positions, and retraction behavior is specific. ESTABLISH CONFIDENCE: For both the child and his family, an atmosphere of confidence and a clear explanation of the lesions and their treatments are essential to break the viscious cycle of pain and anxiety. EXAMINING A CHILD WITH PAIN: Patience is the essence of examining children, facial mimics, reactions, movements and positions all provide essential information. ASSESSING PAIN INTENSITY: Using the visual analogue scale, VAS, children over 5 years of age can show where the pain is on a drawing of the body. For those under 5, questioning the family and looking for specific signs is an essential source of information. The DEGR scale can be used to score prolonged pain in children from 2 to 6 or 8 years of age.
Fournier-Charrière
E
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Service de pédiatrie générale, Hôpital de Bicêtre, Le Kremlin-Bicêtre.
Dommergues
J P
JP
D000208:Acute Disease; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D004630:Emergencies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010146:Pain / Q000175:diagnosis*; D010147:Pain Measurement; D017288:Pain Threshold; D013997:Time Factors
Antalgiques en pédiatrie. Avant la prescription: reconnaître et évaluer la douleur, rassurer.