TMC Launches New Pediatric Pain Management Initiative

Children shouldn’t have to hurt.

Tucson Medical Center is launching a new initiative to make sure that pain is appropriately managed throughout every department of the hospital.

Dr. Rebecca Egbert, the pediatric medical director for TMC Hospice who is taking the lead on the initiative, said assessing children’s pain is tricky not only because they metabolize medications differently but because they’re often too young to fully communicate.

When assessing a 4-year-old, for example, it might be appropriate to line up toys, such as blocks or cars, of varying sizes, she said. Is their pain as small as a Matchbox car? Or as big as a fire truck?

“A 3-year-old will express the concept of pain quite differently than a 10-year-old will,” Egbert said, so it’s important to choose pain assessment tools that match developmental skill levels.”

Maureen Warwick, director of patient care services in the women’s and pediatric departments, said she wants children to have access to excellent pain management in the hospital.

“I want the pain to sort of fade away so they can remember the cool things about their stay. And I want parents to have full confidence that in the event their child experiences pain, we are fully skilled and able to address it and manage it.”

Warwick noted it’s also important to focus on ways of controlling pain outside of medication. It could be as simple as smoothing a sheet for a child who isn’t moving much, using ice, working with breathing techniques, blowing bubbles or turning on the television. A device called a “Buzzy” can scramble pain sensors and distract attention away from the poke of an injection, for example. She said that helps ensure that children, who are already afraid of needles, will be less likely to experience sharp pain when the vibrating device is placed “between the brain and the pain.”

While all departments currently are using some kinds of pain protocol, Dr. Egbert said she is hoping for more consistency, more tools and more continuing education. A committee of physicians, nurses and pharmacy staff are currently evaluating what protocols are in place at each of the departments, and the hospital’s family advisory committee also will have an opportunity to weigh in.

Dr. Egbert said she’s hoping to have a comprehensive pain plan available within six months to a year that will be recommended to every physician at the hospital who sees patients.

“We can’t promise a pain-free experience,” Dr. Egbert said, “but we do want parents to know there is support in place for their child to have good pain management while they’re in the hospital.”

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Tucson Medical Center | 5301 E. Grant Road | Tucson, Arizona 85712 | (520) 327-5461
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