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Module 2: Relieving Pain and Other Symptoms

Pain Assessment in the Absence of Self Report


 Facilitator's Guide Download PDF

This case-based seminar addresses pain assessment in children who are unable to report their pain verbally. The session begins with a 5- to 10-minute introduction to the pain indicators that comprise various pain measurement scales for this population of patients. The facilitator then leads a discussion about three separate cases, two involving neonates and a third involving a toddler who denies that he is in pain despite indications to the contrary. Some of the issues discussed include:

  • Challenge of distinguishing pain from other etiologies with similar clinical indicators.
  • Pain assessment and treatment among a multitude of pressing clinical needs.
  • The importance of observing behavioral and physiological indicators, even in children who have the capacity for verbal communication.
  • Roles of parents and caregivers in pain assessment.

Learning Objectives

Participants will be able to:

  • Recognize the behavioral and physiological indicators that are used to assess pain in the absence of self-report and the ambiguity that sometimes exists regarding the interpretation of these indicators.
  • Use the neonatal/infant pain measurement tool(s) in use at this institution in order to assess pain in children who cannot self-report.
  • Recognize the role of parents' observations in pain assessment, and the value of engaging them as partners in ensuring that a child's pain is managed.
  • Develop strategies for prioritizing a patient's needs and ensuring that pain is treated at the earliest possible time.
  • Recognize the value of observing behavioral and physiological indicators of pain even in children whose cognitive development should allow them to report pain.

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