reflective essay on pain assessment

This website is intended for healthcare professionals

• { $refs.search.focus(); })" aria-controls="searchpanel" :aria-expanded="open" class="hidden lg:inline-flex justify-end text-gray-800 hover:text-primary py-2 px-4 lg:px-0 items-center text-base font-medium"> Search

Search menu

Abbey J, Piller N, De Bellis A The Abbey pain scale: a 1-minute numerical indicator for people with end-stage dementia. Int J Palliat Nurs. 2004; 10:(1)6-13 https://doi.org/10.12968/ijpn.2004.10.1.12013

Boore J, Cook N, Shepherd A. Essentials of anatomy and physiology for nursing practice.Los Angeles: Sage; 2016

Colvin LA, Carty S. Neuropathic pain. In: Colvin LA, Fallon M (eds). Chichester: BMJ Books/Wiley; 2012

Cullen M, MacPherson F. Complementary and alternative strategies. In: Colvin LA, Fallon M (eds). Chichester: BMJ Books/Wiley; 2012

Cunningham S. Pain assessment and management. In: Moore T, Cunningham S (eds). Abingdon: Routledge; 2017

Flasar CE, Perry AG. Pain assessment and basic comfort measures, 8th edn. In: Perry AG, Potter PA, Ostendorf WR (eds). London: Mosby/Elsevier; 2014

Johnson MI. The role of transcutaneous electrical nerve stimulation TENS on pain management. In: Colvin LA, Fallon M (eds). Chichester: BMJ Books/Wiley; 2012

Kettyle A. Pain management, 1st edn. In: Delves-Yates C (ed). London: Sage; 2015

Laws P, Rudall N. Assessment and monitoring of analgesia, sedation, delirium and neuromuscular blockade levels and care. In: Mallet J, Albarran JW, Richardson A (eds). Chichester: Wiley; 2013

Mears J. Pain management. In: Dutton H, Finch J (eds). Chichester: Wiley; 2018

Melzack R. The McGill pain questionnaire: major properties and scoring methods. Pain. 1975; 1:(3)277-299

Smith MT, Muralidharan A. Pain pharmacology and the pharmacological management of pain, 2nd edn. In: Van Griensven H, Strong J, Unruh AM (eds). London: Elsevier; 2014

World Health Organization. WHO's cancer pain ladder for adults. 2019. http://tinyurl.com/y4u2ghok (accessed 28 March 2019)

Adult pain assessment and management

Claire Ford

Lecturer, Adult Nursing, Northumbria University, Newcastle upon Tyne, explain how to reduce the risk of contamination

View articles · Email Claire

Claire Ford, Lecturer, Adult Nursing, Northumbria University, Newcastle upon Tyne ([email protected]) outlines the skills and tools health professionals use to help patients manage pain

For health professionals, one of the most common patient problems they will encounter is pain. Although this is universally experienced, effective assessment and management is sometimes difficult to achieve, as pain is also extremely complex. Therefore, when a patient states they are in pain it is every health professional's duty to listen to what they say, believe that pain is what they say it is, observe for supporting information using appropriate and varied assessment approaches, and act as soon as possible using suitable management strategies.

The holistic assessment and management of pain is important, as pain involves the mind as well as the body, and is activated by a variety of stimuli, including biological, physical, and psychological ( Boore et al, 2016 ). For some patients, the pain they experience can be short-lived and easy to treat, but for others, it can cause significant issues in relation to their overall health and wellbeing ( Flasar and Perry, 2014 ).

Mismanaged pain can affect an individual's mobility, sleep pattern, nutritional and hydration status and can increase their risk of developing depression or becoming socially withdrawn ( Mears, 2018 ). As nurses are the frontline force in healthcare settings, they play a vital role in the treatment of individuals in pain. This article examines and explores some of the holistic nursing assessment and management strategies that can be used by health professionals.

Classifications of pain

Before diving into the assessment process, it is necessary to have a general understanding of the various types of pain that can be experienced, as well as how these are manifested. This understanding will ultimately help to inform management decisions—it is the first step in the assessment process ( Boore et al, 2016 ).

There are several classifications of pain (see Table 1 ); some overlap and patients may present with one or more. Pain can be:

• Acute: pain that is of short duration (less than 3 months) and is reversible
• Chronic: pain that is persistent and has been experienced for more than 3 months
• Nociceptive: pain resulting from stimulation of pain receptors by heat, cold, stretching, vibration or chemicals
• Neuropathic: pain related to sensory abnormalities that can result from damage to the nerves (nerve infection) or neurological dysfunction (a disease in the somatosensory nervous system)
• Inflammation: stimulation of nociceptive processes by chemicals released as part of the inflammatory process
• Somatic: nociceptive processes activated in skin, bones, joints, connective tissues and muscles
• Visceral: nociceptive processes activated in organs (eg stomach, kidneys, gallbladder)
• Referred: pain that is felt a distance from the site of origin. ( Colvin and Carty, 2012 ; Laws and Rudall, 2013 ; Kettyle, 2015 ; Boore et al, 2016 ; Cunningham, 2017 ; Mears, 2018 ).

Individuals react to pain in varying ways; for some, pain is seen as something that should be endured, while for others it can be a debilitating problem, which is impeding their ability to function. Therefore, in order to develop an effective and individually tailored holistic management plan, it is important to understand how the pain is uniquely affecting the individual, from a biopsychosocial perspective ( Flasar and Perry, 2014 ).

To do this, health professionals use a range of tools, such as the skills of observation (the art of noticing), questioning techniques, active listening, measurement and interpretation. No one skill is superior; rather, it is the culmination of information gathered via the various methods that enables a health professional to determine if a patient is in pain, and how this pain is affecting them physically, psychologically, socially, and culturally ( Cunningham, 2017 ) ( Table 2 ).

One of the first skills that can be used is to visually observe the patient, and examine body language, facial expressions, and behaviours, as these provide information about how a person is feeling. For example, an individual in pain may be quiet and withdrawn or very vocal, angry, and irritable. They may display facial grimacing and teeth clenching or exhibit negative body language, guarding and an altered gait.

However, there may be times when an individual may not be able to show behavioural signs of pain, such as when a patient is unconscious. Therefore, physiological response to noxious stimuli can be observed through the measurement of vital signs, such as hypertension, tachycardia, and tachypnoea. Although these observations are routinely used within perioperative and critical care areas, these signs can be present in the absence of pain; consequently, these must be used in conjunction with other assessment strategies ( Laws and Rudall, 2013 ).

Assessment tools

Although vital observations and behavioural manifestations may indicate that a patient is in pain, questioning, measurement and interpretation skills will assist with determining the intensity, severity, and effect of the pain on the patient's wellbeing and quality of life. This process can be aided with the use of specifically designed tools, which act as prompts for health professionals and facilitate the assessment of one or more dimensions.

Unidimensional tools

A visual analogue scale (VAS), numerical rating scale (NRS), or verbal rating scale (VRS) can be quick, easy to use, regularly repeated and do not require complex language. These are limited in terms of the information gained, as examining one specific aspect is not sufficient for adequate and holistic pain management ( Mears, 2018 ). However, for individuals who are unable to communicate or where language barriers exist, unidimensional tools, such as the Wong-Baker FACES tool can be very useful ( Kettyle, 2015 ). The Wong-Baker FACES tool (https://wongbakerfaces.org/), which was originally created for children, has been successfully integrated into the care of older people (with or without cognitive impairment) and is beneficial in facilitating an individual's ability to communicate if they are experiencing pain.

Multidimensional tools

These ask for greater information and measure the quality of pain via affective, evaluative and sensory means. The McGill Pain Questionnaire (MPQ) is one example ( Melzack, 1975 ). This long-established tool is often used to assess individuals who are experiencing chronic pain. However, due to its higher levels of complexity health professionals can sometimes find this tool more difficult to use, especially if unfamiliar with it. The Abbey pain scale ( Abbey et al, 2004 ) is another multidimensional tool that has proven to be beneficial for assessing pain in older adults who are unable to articulate their needs.

OPQRST and SOCRATES are just two examples of mnemonic aids, which can be useful and require no equipment as they use mental assessment processes only. OPQRST stands for onset, provokes, quality, radiates, severity and time. SOCRATES stands for site, onset, character, radiates, associations, timing, exacerbating factors and severity.

However, regardless of which tool or mnemonic is used, because pain presentations are often unique pain assessment will not be successful if the health professional fails to ascertain and interpret the signs and symptoms, uses the tools inappropriately, and does not apply a person-centred approach to the overall assessment process, ie uses the wrong tool for the wrong patient.

Management strategies

The primary goal for all patients is to pre-empt and prevent pain from occurring in the first instance; however, if pain cannot be avoided, optimal analgesic management is vital.

The word analgesia, ‘to be without feeling of pain’, is derived from the Greek language, and in terms of pain management can relate to medication and alternative interventions ( Laws and Rudall, 2013 ). Hence, pain management plans should incorporate a multi-modal approach in order to successfully and holistically treat patients' pain ( Flasar and Perry, 2014 ). Boore et al (2016) argued that this is an effective way to manage pain, but stressed that the decisions about which management strategies to use, also need to take into consideration the context of the clinical situation, the patient's level of acuity, the environment and physical space, and the availability of resources.

Pharmacological

One very effective strategy that health professionals have within their management arsenal is the use of pharmacological treatments. The choice of treatment depends on whether the pain is nociceptive, neuropathic, inflammatory or of mixed origin. There are three main categories: opioids, non-opioids/non-steroidal anti-inflammatories, and adjuvants/co-analgesics ( Table 3 ). The most efficient pharmacological regime, for moderate to severe pain (ie cancer-related pain) often incorporates a combined approach, by administrating a specific drug in conjunction with adjuvants or co-analgesics ( Figure 1 ).

Non-pharmacological

Pharmacological treatments are not the only strategy at health professionals' disposal, and true holistic management cannot be achieved without the incorporation of other non-pharmacological therapies. Some of these interventions are long-standing, are ingrained in some traditional medical practices and, when used correctly, can enhance patients' feelings of empowerment and involvement ( Flasar and Perry, 2014 ). However, due to limited resources, funding, space, time, knowledge of use, and personal beliefs, some therapies are not fully used or embraced ( Cullen and MacPherson, 2012 ).

These can be placed into three main groups ( Table 4 ), and the choice of which to use will depend on patients' preferences and existing coping mechanisms. The following strategies have been highlighted as they align with the fundamental core values of care and compassion, and require very little in terms of resources or time.

• Distraction: this can take various forms, such as talking to the patient about their specific hobbies. This basic skill often requires no equipment, can be done anywhere and is a useful way of taking the patient's mind off their pain
• Imagery/meditation: this management technique takes distraction therapy one step further by using a more structured approach
• Therapeutic touch and massage: for centuries, the therapeutic placing of hands has proven to be a useful skill, and has beneficial physiological (stimulation of A-beta fibres, which restrict pain pathways) and psychological properties ( Kettyle, 2015 ).
• Environment: sound, lighting and the temperature of the patient's immediate environment have been shown to heighten or reduce perceptions of pain
• Body positioning and comfort: this can be used to help patients cope with the pain levels they are experiencing and may reduce the pain associated with nociceptive and inflammatory pain signals
• Thermoregulation: for some types of pain, it has been shown that the use of heat or cold packs can help reduce pain experiences. However, care needs to be taken if these treatments are to be used on postoperative sites and areas with skin-related contraindications
• Electrostimulation: this technique is non-invasive and uses pulsed electrical currents to stimulate A-beta fibres, which inhibit the transmission of nociceptive signals in the pain pathway ( Johnson, 2012 ).

Successful pain assessment and management can only be achieved if health professionals adopt a holistic and multimodal approach, incorporating the use of person-centred assessment processes, compassionate communication and a variety of management strategies, chosen in partnership with the patient.

LEARNING OUTCOMES

• Have a basic understanding of some of the classifications of pain
• Improve awareness of the skills required to assess and manage an individual's pain
• Explore some of the tools used to assist with the assessment of pain
• Understand some of the strategies used to manage pain
• Examine some of the barriers to effective pain assessment and management

• Cancer Nursing Practice
• Emergency Nurse
• Evidence-Based Nursing
• Learning Disability Practice
• Mental Health Practice
• Nurse Researcher
• Nursing Children and Young People
• Nursing Management
• Nursing Older People
• Nursing Standard
• Primary Health Care
• RCN Nursing Awards
• Nursing Live
• Nursing Careers and Job Fairs
• CPD webinars on-demand
• --> Advanced -->

• Clinical articles
• CPD articles
• CPD Quizzes
• Expert advice
• Clinical placements
• Study skills
• Clinical skills
• University life
• Person-centred care
• Career advice
• Revalidation

Evidence and practice    

Recognising and assessing acute pain, carolyn mackintosh-franklin senior lecturer, university of manchester, manchester, england.

• To enhance your awareness of the barriers that may prevent you from recognising acute pain in patients

• To recognise how you can overcome the barriers that prevent the recognition of pain

• To understand the components of a comprehensive pain assessment

This article considers two areas of practice that are fundamental to the provision of high-quality nursing care for people experiencing acute pain: the initial recognition of pain, and the formal assessment of pain. The initial recognition of a patient’s pain is a subject that is frequently overlooked in the literature. However, if nurses are unable to identify that a patient is experiencing pain, then a formal pain assessment may not take place, which in turn negatively affects the quality of any subsequent pain management. This article explores some of the barriers to the initial recognition of pain and examines how a formal pain assessment can support optimal patient care.

Nursing Standard . doi: 10.7748/ns.2020.e11501

This article has been subject to external double-blind peer review and checked for plagiarism using automated software

[email protected]

None declared

Mackintosh-Franklin C (2020) Recognising and assessing acute pain. Nursing Standard. doi: 10.7748/ns.2020.e11501

Published online: 03 December 2020

acute pain - assessment - clinical - pain - pain assessment - pain management - patient assessment - professionalCarolyn Mackintosh-Franklin

User not found

Want to read more?

Already have access log in, 3-month trial offer for £5.25/month.

• Unlimited access to all 10 RCNi Journals
• RCNi Learning featuring over 175 modules to easily earn CPD time
• NMC-compliant RCNi Revalidation Portfolio to stay on track with your progress
• Personalised newsletters tailored to your interests
• A customisable dashboard with over 200 topics

Alternatively, you can purchase access to this article for the next seven days. Buy now

Are you a student? Our student subscription has content especially for you. Find out more

01 May 2024 / Vol 39 issue 5

TABLE OF CONTENTS

DIGITAL EDITION

• LATEST ISSUE
• SIGN UP FOR E-ALERT
• WRITE FOR US
• PERMISSIONS

Share article: Recognising and assessing acute pain

We use cookies on this site to enhance your user experience.

By clicking any link on this page you are giving your consent for us to set cookies.

Reflective practice: providing safe quality patient-centered pain management

Affiliations.

• 1 School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
• 2 School of Nursing, Ringgold Standard Institution, University of Northern Colorado, Greeley, CO, USA.
• PMID: 28147900
• DOI: 10.2217/pmt-2016-0053

Effective pain management continues to baffle clinicians in spite of numerous evidence-based guidelines and standards, focused clinical interventions and standardized assessments. Reflective practice is a mindful approach to practice that grounds clinicians in the moment with the individual patient to ask questions and then to listen to the patient's message about their pain experience. Reflective practice helps meld theoretical knowledge with lessons from experience to rethink mechanistic responses to patient pain. The subjective nature of pain means no two patients have the same experience, and, evidence based best practices are to be applied within the patient's preferences and context. The paper uses a case study to illustrate how to apply reflective practice to integrate the interprofessional quality and safety competencies to provide patient-centered pain management. Applying reflective questions throughout the care experience by all members of the healthcare team provides a mindful approach that focuses care on the individual patient.

Keywords: pain; pain management; quality and safety competencies.

• Culturally Competent Care*
• Pain Management / methods*
• Patient-Centered Care / methods*

Paediatric Emergency Case: Pain Management in a Child Reflective Essay

Introduction.

Working as a nurse in pediatrics entails much patience and understanding of the young patients who have limited language skills to express how they feel. It is quite a challenge to determine how I can help a child in intense pain when I do not know the nature of his or her pain and the parent is likewise frantic and helpless and they are just looking at me to provide them with the much-needed relief. This paper will deal with my own experience in helping a child in pain manage her situation. I would like to share my own reflective journey through my experience to serve as a lesson to readers who might undergo the same dilemma in their future nursing practice. To organize my reflection, I shall follow Gibbs’ Reflective Cycle (Jasper, 2003) so that readers can fully understand what was going on inside of me as I dealt with a child in pain and the process I went through to resolve the problem situation.

Description

A three-year-old toddler was brought to the emergency room one day when I was the pediatric nurse on duty. She cried incessantly and kept mumbling the word “ouwieeee!”. Her mother was very anxious and kept giving information as to when the child began feeling pain. In addition, she informed that she initially gave the child the usual Paracetamol medicine, but it did not work. She rushed her daughter to the hospital because she has been crying for over an hour and complaining of severe pain, but she could not tell where it hurt.

Since I have ample experience working with sick children, I felt confident that I would be able to handle the situation. However, I remember that most of the child patients I had were older and could verbally communicate well. I realized that it was my first time handling a frantic toddler who had limited verbal skills and I needed to ease her pain as soon as possible because I can tell she was suffering so much. My heart went out to the beautiful crying child, whose hair was all wet from sweat and tears. I also pitied her mother who looked so helpless in the situation as her child clung desperately to her. Looking at the mother and child, I felt I had to take charge and do something to provide immediate relief to the child.

In evaluating the situation, I knew that the pain in the child was prolonged and the agitation it caused the child were negative factors I had to contend with. To make matters worse, the child was unable to provide me with the necessary information I needed to give a preliminary diagnosis, due to the fact that her verbal skills were limited. We had to wait for the pediatrician to come and the delay was caused by the large number of pediatric patients that came into the emergency room that day, therefore we were short of doctors. On the other hand, the fact that the mother was there with a child gave her the support she needed. It was really helpful that the mother was very cooperative and open to suggestions. Parents are usually the most affected when their children are in pain. Walsh & Barfield (2006) found that parents were willing to shell out any amount of money just to see their child’s suffering from pain end. Their study focused on giving parents the choice of whether or not they would pay for a painless insertion of the IV catheter and their preference for the length of stay of their child in the medical facility. Most of the parents in the study, the majority were mothers, chose to stay longer and pay money to ensure a painless IV start for their child.

Observing how she tried to comfort her child was very helpful to me because I wanted to learn some strategies she used so I can apply them myself. I had to take the child’s temperature and blood pressure but needed her to be relaxed. I remembered that it was my duty to be a leader in such a situation (Swanwick & McKimm, 2011). What comes to mind is my favorite leadership model by Kouzes and Posner (2007) who prescribed five effective leadership practices. These are to challenge, inspire, enable, model, and encourage their followers. What was needed in this situation was to inspire the child to calm down and envision that soon the pain would go away. I also needed to convince her that she was strong enough to do it. I should also have enabled her mother to help her child ease the pain and to let her know that she would survive this trying situation. I needed to enjoin her to be my co-model of calmness and relaxation so that the child herself would follow suit (Duffield et al., 2007).

Gauging from the number of patients in the emergency room, I knew that it would take more time until the doctor comes to our aid. I needed to take her vital signs so that it is ready for assessment when the doctor arrives, but before I could do that, I needed to calm the patient down (Runciman, Merry & Walton, 2007). On feeling her forehead, she was very warm, but I needed to take her temperature to check if she was running a fever as well as check her blood pressure and other vital signs. From my experience, I thought the child was suffering from a middle ear infection which can be very painful, especially to a toddler.

The pediatric ward has several children’s books and toys to entertain children. I ran to get a toy that I believed would distract my patient and calm her down. I got a squeaky bunny and handed it to her, but she brushed it off. I made the bunny “talk” and asked the child what was wrong, using my high-pitched voice. That got the child’s attention. I signaled to the mother to help me out and she started asking questions to the bunny to which the bunny “answered”. The child stopped crying and stared at the bunny. When I squeaked it and made a funny sound, she was surprised and she started smiling. The bunny told her he was in pain too and his long ears bothered him. I had to move his ears to show the child it needed attention. The bunny also told the child I could help him, so I took his temperature using the ear thermometer. Later on, the child also allowed me to take her temperature. After a few more minutes, she was engaged with playing with the toy. She was finally calm so I was able to take her vital signs.

Action Plan

My actions successfully helped calm down the patient enabling me to take her vital signs and get her ready for the doctor. Using the toy bunny helped a lot. I would do the same thing in a similar situation with another anxious pre-verbal child and engage the parent in interacting with the child. I would observe what the child may be interested in and use it to gain his or her trust and rapport. I need to brush up on my interactive skills with young children and read up on how to stimulate them.

Kenny (2001) explained that young children are disadvantaged in pain management due to their lack of verbal ability and personal power to demand appropriate pain management from health professionals. At a young age, they may not fully understand the reason for their suffering. Several factors influence children’s pain and behavior. Some of these are environmental cues, situational factors, and familial factors (Rajasagaram, Taylor, Braitberg, Pearsell, & Capp, 2009). Memories of poorly managed pain in certain medical procedures heighten children’s perception of pain, and so respond to even the slightest pain in a more exaggerated manner. These traumatized children present greater behavioral distress during the procedures. It follows that children’s memories of their previous experiences become important determinants of what they will expect in future pain experiences and anticipatory anxiety, which then increases their pain during the procedure (Chen, Bush & Zeltzer, 1997). With preverbal children or those who have cognitive delays or disabilities, it may be worse due to a more difficult assessment of the pain experienced by the health care provider because of communication barriers. With these children, health providers resort to analgesic treatments and the engagement of parental support for more efficient pain assessment and management (Rajasagaram et al., 2009).

Getting the participation of the child’s mother was also very helpful, as the child needed someone she trusts to deal with the situation she was in. The report of O’Malley, Brown & Krug (2008) endorses the idea of family support especially in the emergency department of a medical facility. They studied its adaptability incorporating family-centered approaches as opposed to strictly patient-centered care. There is much value in having the comforting presence of a parent throughout the chaotic process of emergency care for children.

Reflecting on a particular experience, event, or interaction from my own practice helps in clarifying my own philosophy and beliefs in good nursing practices (Chang & Daly, 2008). Gibbs’ model of reflection is a very useful method for doing that. Even if I may earn positive feedback on my performance from my supervisors and patients, I cannot be complacent knowing I still have a lot to learn. Knowing how I perform in certain tasks can help me gain more confidence that I am doing well, or make me realize my mistakes or the areas that I need improvement in. The experience I had with the frantic toddler in the emergency room was new for me and I am grateful for such an experience even if it made me frantic as well deep inside. I know that my duty was to keep the patient calm and safe while providing relief and my priority was to help the patient become comfortable (Wolff & Taylor, 2009).

Chang, E., & Daly, J. (2008). Transitions in nursing: Preparing for professional practice (2nd ed.). Sydney: Elsevier.

Chen, E., Bush, J., & Zeltzer, L. (1997) Psychologic Issues in Pediatric Pain Management , Current Pain and Headache Reports 1 (2):153-164.

Duffield C., Roche M., O’Brian-Pallas L., Diers, D., Aisbett, C.,… Hall, J. (2007). Getting it all together: Nurses their work environment and patient safety. Sydney: Centre for Health Services Management, University of Technology.

Jasper, M. (2003) Beginning Reflective Practice – Foundations in Nursing and Health Care. Nelson Thornes. Cheltenham.

Kenny, N. P. (2001). The politics of pediatric pain. In G. A. Finley & P. J. McGrath (Eds.), Acute and procedure pain in infants and children: Progress in pain research and management, Vol. 20 (pp. 147–158). Seattle: ISAP Press.

Kouzes, J., & Posner, B. (2007). The leadership challenge (4th ed.). San Francisco, Ca: Jossey- Bass.

O’Malley, P., Brown, K., & Krug, S. (2008). Patient and family-centered care of children in the Emergency Department. Journal of Pediatrics , 122 (2): 511-521.

Rajasagaram, U., Taylor, D., Braitberg, G., Pearsell, J. P., & Capp, B. A. (2009) Paediatric pain assessment: Differences between triage nurse, child and parent. Journal of Paediatrics and Child Health, 45 (4): 199–203.

Runciman, B., Merry, A., & Walton, M. (2007). Safety and ethics in healthcare – A guide to getting it right. Aldershot: Ashgate.

Swanwick, T., & McKimm, J. (2011). ABC of Clinical Leadership . BMJ Books, Willey- Blackwell.

Wolff, A., & Taylor, S. (2009). Enhancing patient care. A practical guide for improving quality and safety in hospitals . Strawberry Hills, N.S.W.: MJA books.

• Chicago (A-D)
• Chicago (N-B)

IvyPanda. (2024, March 2). Paediatric Emergency Case: Pain Management in a Child. https://ivypanda.com/essays/paediatric-emergency-case/

"Paediatric Emergency Case: Pain Management in a Child." IvyPanda , 2 Mar. 2024, ivypanda.com/essays/paediatric-emergency-case/.

IvyPanda . (2024) 'Paediatric Emergency Case: Pain Management in a Child'. 2 March.

IvyPanda . 2024. "Paediatric Emergency Case: Pain Management in a Child." March 2, 2024. https://ivypanda.com/essays/paediatric-emergency-case/.

1. IvyPanda . "Paediatric Emergency Case: Pain Management in a Child." March 2, 2024. https://ivypanda.com/essays/paediatric-emergency-case/.

Bibliography

IvyPanda . "Paediatric Emergency Case: Pain Management in a Child." March 2, 2024. https://ivypanda.com/essays/paediatric-emergency-case/.

• Rainbow International Children’s Hospital’s Plan
• The Healthcare of Children in the Community
• Nursing Research: Models and Theories
• Obesity Among Children in San Diego, California
• Otitis Media (OM) Among Young Children
• Childhood Obesity: The New Epidemic
• The Studies of Childhood Obesity
• The Ingestion of Magnets in Young Children: Nursing Care Plan