The Cribsiders S7 Ep154: Ache It ‘Til You Make It: Approach to Pain in Children
Oct 1, 2025
Dr. Emmanuel Alalade, a pediatric anesthesiologist at Children's Healthcare of Atlanta, dives deep into the world of pediatric pain management. He shares strategies for assessing pain in children, discussing observational cues and effective pain scales. Dr. Alalade emphasizes the importance of multimodal approaches, combining medications like acetaminophen and ibuprofen, while also outlining non-pharmacologic techniques such as distraction and VR. He addresses the racial disparities in pain treatment and advocates for informed, compassionate care for young patients.
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Start With Observation And Caregiver Input
- Observe behavior and ask caregivers for baseline cues before relying on numeric scales.
- Treat distress first (e.g., give analgesia) to enable exam and better assessment.
Use Age-Appropriate Pain Scales
- Use age-appropriate pain tools: faces for preschoolers, FLACC for nonverbal infants.
- Convert FLACC to a 0–10 frame to compare across encounters.
Maximize Acetaminophen And Ibuprofen
- Dose acetaminophen (15 mg/kg) and ibuprofen (10 mg/kg) correctly and stagger them around the clock.
- Schedule, don't just give PRN; alternating every three hours improves control.