401) Visualising and Treating Pain in Children

Background: Pain is one of the most under diagnosed, under treated medical problems, particularly in children. 1,2 Ten percent of hospitalized children show features of chronic pain. 2  Chronic pain conservative estimates 20% to 35% of children and adolescents affected worldwide. 2 Pain costs has been extrapolated to $19.5 billion USA annually. 2, 3 Problem: Current diagnostic methods rely on self-reports and caregivers perception. Young children can be challenging if they are non-verbal or have developmental disabilities and depends on his or her intellectual and social development. 4 Emergency primary care physicians report a need for pain assessment procedures in children and youth. 5 Results: The law of pain; the origin of all pain is inflammation and the inflammatory response. 6 Using four FDA approved devices combined can augment clinical palpation. Data comparisons are made between a painful and non-painful point, a display shows differential amounts: Pain Pressure Thresholds Tolerances “PPT's”, Temperature, Sympathetic Skin Response and Tissue Sounds. 7 When inflammation is gone, treatment outcomes software shows no more difference between comparison points. Gamification will enhance patient engagement improving outcomes. 8 Sensors can be worn, air cells apply intermittent pneumatic compression massage therapy, squeezes edema to regions with normal lymphatic drainage. 9 Disease detection once relied on physician's palpation skills to evaluate the soft tissues for signs of inflammation heat ( calor ), pain ( dolor ), redness ( rubor ), and swelling ( tumor ), fluor (secretion). Biosensors could supplement palpation for musculoskeletal pain, the most common single type of chronic pain; chronic low back pain is the most prevalent. 10 Conclusion: If pain were assessed with the same zeal as other vital signs are, it would have a much better chance of being treated properly. We need to train doctors and nurses to treat pain as a vital sign. 11 JCAHO regulations regard pain as “the fifth vital sign”, this approach provides Based Medicine/Practices (EBM/EBP).