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By Amanda Gwee, Romi Rimer, Michael Marks

''From Royal kid's clinic in Melbourne.''

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For example, staff and parents should focus on the helpful things the child did during the procedure. Staff may also like to suggest alternative techniques for any further procedures that may be planned. 3. Assessment General principles r r r r Integrated multidisciplinary assessment and management is ideal. Assess the physical and psychosocial causes for the child’s presentation. The factors maintaining persistent pain will determine specific treatment. An integrated approach with good communication between the involved healthcare providers is ideal.

R Remember that sedatives alone are not analgesics. r It is difficult to assess pain and the effects of analgesia and sedation in neonates and children with cognitive impairments. Before the procedure General principles – preparation is the key r r r r r r r r r 22 Prepare yourself and the other staff involved. Ensure parents and the child understand what the procedure involves. Ideally, prepare the child <6 years immediately before the procedure and >6 years 1 week before. Avoid medical jargon; explain what is going to happen and in what order.

R A thorough search for the cause of pain will guide treatment options. 28 3. Pain Management Sleep disturbance r r r r r Occurs frequently and has implications for the functioning of the whole family. Address poor sleep hygeine. Address underlying worries and concerns. TCAD, via their analgesic and sedative effects, may be useful in reducing the frequency of waking. Melatonin may also be useful. au/anaes/pain management/Acute Pain Management CPMS/ – RCH Acute Pain Management Service Clinical Practice Guidelines.

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