Background

What's the purpose of the RCN children's pain guideline?

The guideline has been produced to support the recognition and assessment of acute pain in children for anyone involved in their care.
 
It identifies reliable and valid tools for measuring pain intensity that are appropriate for neonates, preverbal infants and verbal children and makes a series of key recommendations regarding timing and triggers for formal pain assessment.
 
The guideline also describes the validated tools, helping health care professionals select among them according to different settings. There is an algorithm to help with the selection of these tools. View the algorithm of validated pain scales (PDF 134.1KB) [see how to access PDF files].

Why is the guideline important?

Pain assessment is crucial in ensuring that effective processes and procedures are used to prevent or minimise children's pain.
 
Health professionals, parents and carers have a responsibility to learn the language of pain expression by children, to listen carefully to their self-reports of pain and to attend to behavioural cues. The detection of children's pain can be improved by using pain measurement tools that are appropriate to their cognitive development and can be understood by the adults caring for them.

Why update the children's pain guideline?

Pain recognition and assessment is a developing area. There is new research emerging all the time into the best way to approach it and it was important to update the guideline to capture the findings from this research.
 
The guideline was developed through a systematic review and appraisal of the published evidence to date, and complemented the Association of Paediatric Anaesthetist's 2008 edition of Good Practice in postoperative and procedural pain. The APA guideline has now been updated and published  in a second edition in 2012 at Good Practice in postoperative and procedural pain. For further information see Guideline downloads.

Since the publication of the previous version there has been new research carried out about assessing pain in children with cognitive impairments, and the updated version includes a whole new section about this.

An article describing the development process undertaken by the RCN to update the guideline has been published:
Stapelkamp C, Carter B, Gordon J and Watts C (2011) Assessment of acute pain in children: development of evidence-based guidelines, International Journal of Evidence-Based Healthcare 9(1) March pp.39-50.
International Journal of Evidence-Based Healthcare is available via the RCN e-journals, but please note that full text of articles is embargoed for a year. An abstract of the article is also available on the publishers website – see International Journal of Evidence-Based Healthcare volume 9, Issue 1 2011.

Expertise

The guideline has been developed by a guideline development group (GDG) with expertise in pain recognition and assessment in children (see the full GDG membership).

In addition, the RCN children's pain guideline has been formally endorsed by the following organisations:

The guideline is also supported by the Royal College of Anaesthetists Faculty of Pain Medicine.