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Pediatr Emerg Med Pract. 2019 Aug;16(8):1-24. Epub 2019 Aug 2.

Pediatric pain management in the emergency department.

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Associate Professor, Department of Pediatrics, University of Washington, Seattle, WA.
Attending Physician, Emergency Medicine, Cook Children's Medical Center, Fort Worth, TX.
Assistant Dean for Graduate Medical Education & Faculty Development, Associate Professor of Clinical Emergency Medicine & Pediatrics, Fellowship Director for Pediatric Emergency Medicine, Departments of Emergency Medicine & Pediatrics, Indiana University School of Medicine, Indianapolis, IN.


Adequate analgesia is critical in the management of pediatric patients in the emergency department. Suboptimal treatment of pain can have deleterious effects in the short term, and it can also affect a patient's development and reaction to future painful experiences. Tools exist to quantify a patient's pain level regardless of age or developmental stage. Both pharmacologic and nonpharmacologic methods can be effective in the management of pediatric pain. Emergency clinicians must remain vigilant in the recognition, treatment, and reassessment of pediatric pain, as patients' developmental level may limit their ability to independently express their pain experience without prompting or tools. This issue reviews pain scales that are suitable for pediatric patients and discusses pediatric pain management using nonpharmacologic methods, topical, local, and regional anesthesia as well as systemic agents.


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