Case of the Month #2: Acute pain assessment in a child

Published: 10/02/2021

Overview

Author: Dr Helen Laycock
 

An 8-year-old child following a laparotomy for a perforated appendix and pelvic abscess spends 48-hr on the Paediatric Intensive Care Unit. During the first 24-hours she is ventilated and receives dexmedetomidine and morphine infusions as sedation and analgesia. The child has no past medical history, was not taking any regular medications prior to this admission and has no known drug allergies. They live with their parents and a 10-year-old sister and there is no family history of any illnesses. She attends school, is doing well academically and has many friends. 

  • During the first 48-hours whilst she is being cared for on the Paediatric Intensive Care Unit what pain assessment tools could be used? 
  • After discharge to the surgical ward she is prescribed regular paracetamol, regular ibuprofen and has a morphine PCA which she is able to utilise to good effect. On the ward the nursing staff assess her pain, what pain assessment tools could be used?