Pediatric clinics of North America
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This article focuses on the methods of pain measurement and assessment in children. The concepts of reliability and validity and the available types of physiologic, self-report, and behavioral measures are addressed. Methods of pain assessment in infants and toddlers, preschoolers, school-aged children, and adolescents are detailed. Finally, some practical suggestions for pediatric pain assessment are provided.
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Pediatr. Clin. North Am. · Aug 1989
ReviewThe management of pain associated with pediatric procedures.
This article provides guidelines for the psychological and pharmacologic management of pain and anxiety for children undergoing medical procedures. The goals of intervention are presented, as well as issues warranting consideration in planning intervention to reduce procedure-related distress.
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In spite of the many possible methods of pain control in the burned child satisfactory pain management may still be a problem, at times formidable. The most fruitful approach would seem to be frequent assessment of pain in the individual patient with a readiness to try alternative or additional measures when relief seems inadequate. In this way the most effective analgesic agent(s), route(s), and frequency of administration, as well as nonpharmacologic methods, can be determined for each child. ⋯ Nevertheless, careful observation of physiologic signs such as heart rate and blood pressure, facial expressions, body movement and position, and the quality of an infant's cries may in sum be sufficient to evaluate the intensity of pain. Monitoring of analgesic plasma levels to ascertain that they are within the ranges established for good analgesia and even determination of beta-endorphin blood levels may also aid in judging the adequacy of analgesia. By tailoring pain management methods to the needs of each child it may be possible to keep pain at acceptable levels in victims of burn injury.
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The United States must improve its efforts to reduce teen pregnancy. We occupy an alarming position in the developed world from the standpoint of the magnitude of the pregnancy issue. While our society promotes sexuality to sell all sorts of consumer goods, it still refuses for the most part to make contraceptives familiar and available to sexually active teens. ⋯ Their children will have limited futures. Only by stepping up our efforts to prevent early pregnancy will we make possible a life of opportunity and choice for the young people of our country. Consequences will be costly and tragic if we do not.
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Acute and chronic pelvic pain in the adolescent patient needs to be taken seriously. In most cases, an underlying cause can be identified. Under no circumstances should the label of psychogenic pain be offered on these teenagers without a prior negative laparoscopy. Adequate diagnosis and early therapy are essential to improve the quality of life and preserve the reproductive prognosis in these young patients.