Untreated pain in childhood may have ramifications well into adulthood. Opioid medications have an important role in care for moderate to severe pain that cannot be relieved by first-line interventions, but clinicians must approach opioid use in the emergency department in an evidence-based, socially responsible manner.
Our recent issue Responsible and Safe Use of Opioids in Children and Adolescents in the Emergency Department reviews evidence-based approaches to assessment and management of pain in children and adolescents, with a focus on optimizing nonopioid pain management as a first approach and using opioid medications safely, when appropriate.
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Here are a few key points:
- Assess pain globally, using a developmentally appropriate pain scale. Ask the family about the impact of the injury on the child’s functioning. (See Table 1 in issue.) This allows for a better picture of the extent of the pain and can inform the pain management plan.
- Treat pain in a multimodal fashion. Combine physical, psychological, and pharmacological interventions to create the best pain-relief plan. Parents/caregivers and child life specialist involvement form an important part of this planning.
- Based on efficacy and adverse effect profile, ibuprofen is the first-line oral agent in treatment, particularly for acute musculoskeletal injuries.
Last Updated on January 25, 2023