Pain assessment in a children's A&E: a critical analysis

In this particular children's A&E department it is evident that pain assessment is a high priority among the nursing staff. Pain is routinely assessed on every child during triage, so analgesia is given as soon as possible and children are not left suffering pain for an unnecessary length of time. However, because pain is not routinely reassessed it is often unknown whether the pain has been fully relieved. It appears that not all the resources available for assessing a child's pain are utilised, resulting in the possibility that not all aspects of a child's pain are assessed. Pain is assessed using the child's self reports or nurses' observations. It has been shown that these are not always appropriate and there is need to use a number of different tools for assessing a child's pain. There is also the need for a validated tool to assess pain in younger children. When referring back to McGrath and Unruh's (1987) definitions of pain measurement and pain assessment, it could be concluded that nurses in the children's A&E department measure pain, but, due to the lack of emphasis which is placed on the different aspects of pain and the limited range of tools which are used, they do not assess pain effectively. In order for pain assessment to be improved, nurses need to be made aware of the different aspects of pain and different tools which are available to assess them in children. This could be initiated by implementing the RCN (1999) guidelines for pain recognition and assessment in children.