‘Just little tricks’: an exploration of treating children in pain
Abstract
Background:
Pain is one of the commonest symptoms in patients of all ages presenting to ambulance services. Children in pain make up a relatively small proportion of the number of those attended by prehospital care and pain management is needed in only 40% of cases. This might go some way to explain why the management of paediatric pain is perceived to be poor.
Aim:
The primary aim of this study was to explore the experiences of UK paramedics in treating children in pain.
Methods:
A phenomenological study was undertaken using a purposeful sample of UK paramedics (
Results:
Five themes became apparent through analysis—preparation and education; adaptation and change of approach; organisational and legal factors; support and guidance; familial and carer impact—with some crossover between themes noted.
Conclusion:
Clinicians are aware of multimodal techniques for managing pain in children but are often less confident in the use of pharmacological than non-pharmacological management methods. Advances in the use of technology in practice have enabled clinicians to use alternative measures to manage children in pain. However, while using these methods, practitioners lack confidence that they are meeting social expectations of their roles.
Pain is a common symptom associated with injury and illness, and is frequently the primary reason a patient will seek support or guidance from healthcare services. Despite the prevalence of pain, it is acknowledged that children's and adolescents’ pain is poorly assessed and managed (Friedland and Kulick, 1994; Hennes et al, 2005; Swor et al, 2005; Izsak et al, 2008; Brown et al, 2017; 2019).
Prehospital services’ encounters with children, including those of a traumatic nature, commonly involve paediatric patients in pain (Samuel et al, 2015). Despite this, evidence suggests that very few children in this setting receive adequate analgesia even though there is potential for skilled clinicians to deliver such care (Hennes et al, 2005; Swor et al, 2005; Shaw et al, 2015; Whitley and Bath-Hextall, 2017).
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