Assessment of pain after injury in the pediatric patient: child and parent perceptions.
OBJECTIVE
Pain is an inevitable consequence of injury. Accurate assessment and treatment of a child's pain after injury is essential. This study sought to describe children's pain with injury and to elucidate the concordance of parental and self-reported pain in a pediatric traffic-injured population.


METHODS
Children (5 to 17 years) admitted for traffic-related injuries and 1 parent were invited to participate in the study. Consented participants were interviewed within 1 month of injury. Participants were asked to rate current and worst pain on 2 validated pediatric pain assessment scales (Bieri Faces Pain Scale and Color Analogue Scale). Demographic, crash, and injury data were abstracted from the medical record.


RESULTS
Data from 276 child-parent dyads show that most children reported clinically significant pain initially after injury. Greater "worst pain" ratings did not correlate with injury severity but were associated with loss of consciousness and extremity fracture. Generally, parent-report of child's pain was concordant with child self-report.


CONCLUSIONS
This study shows the feasibility of pain assessment for pediatric injury using 2 validated scales and the appropriateness of parental report when the child is not able to provide self-report. Because pain was not correlated with injury severity, pain assessment and intervention for all children with traumatic injuries is strongly recommended.
Baxt
Chiara
C
Children's Hospital of Philadelphia, TraumaLink, Philadelphia, PA 19104, USA.
Kassam-Adams
Nancy
N
Nance
Michael L
ML
Vivarelli-O'neill
Cara
C
Winston
Flaura K
FK
D000063:Accidents, Traffic; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003128:Coma / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D005240:Feasibility Studies; D005260:Female; D050723:Fractures, Bone / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D008297:Male; D010146:Pain / Q000209:etiology / Q000523:psychology; D010147:Pain Measurement; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology; D010361:Patients / Q000523:psychology; D011446:Prospective Studies; D015599:Trauma Severity Indices