Published online November 1, 2004
PEDIATRICS Vol. 114 No. 5 November 2004, pp. 1348-1356 (doi:10.1542/peds.2004-1752)
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CLINICAL REPORT

Relief of Pain and Anxiety in Pediatric Patients in Emergency Medical Systems

William T. Zempsky, MD, Joseph P. Cravero, MD and Committee on Pediatric Emergency Medicine, and Section on Anesthesiology and Pain Medicine

Whether a component of a disease process, the result of acute injury, or a product of a diagnostic or therapeutic procedure, pain should be relieved and stress should be decreased for pediatric patients. Control of pain and stress for children who enter into the emergency medical system, from the prehospital arena to the emergency department, is a vital component of emergency care. Any barriers that prevent appropriate and timely administration of analgesia to the child who requires emergency medical treatment should be eliminated. Although more research and innovation are needed, every opportunity should be taken to use available methods of pain control. A systematic approach to pain management and anxiolysis, including staff education and protocol development, can have a positive effect on providing comfort to children in the emergency setting.

Key Words: pain • stress • anxiety • analgesia • opiates • topical anesthesia

Abbreviations: ED, emergency department • EMS, emergency medical services • EMLA, eutectic mixture of local anesthetics • LMX4, liposomal 4% lidocaine cream • LET, lidocaine, epinephrine, and tetracaine • AAP, American Academy of Pediatrics • ASA, American Society of Anesthesiologists • NPO, nil per os




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