Pediatric pain in hospitals - undertreated?

There’s nothing that pisses me off more than health care professionals being stingy with analgesia. When I teach paramedic students I emphasise the point to them over and over again. If someone tells you they are in pain, your job is to treat it and try your hardest to eliminate it using all of the tools at your disposal. It is not your job to make judgements/decide whether people are telling the truth or whether they ‘deserve’ it. Just treat them properly.

I was in A&E having fallen from height. Suspected fractures and a smashed face. No one gave me any pain relief. It's not just paed.

One place I have to give a shout out to is Watford A&E. They are fabulous for giving pain relief at triage to all who needs it. And my son got given a pain relief pessary at 16. He yelled but apparently the instant pain relief was totally worth it.

Maternity pain relief is also horrendous. It’s like gas and air costs come out of the midwives salary!

Yanbu I've seen children being given bloody heat packs when crying in pain instead of actual pain relief too. For properly diagnosed horrific conditions. I dont get it.

This - that doctor should be struck off.
I would like to see how he would react if it was him left in agony

Is it because they're only allowed to administer jist ibuprofen and paracetamol at a certain age? With severe pain these can barely touch the sides and adults are given stronger medication. Xx

My experience at 15 with appendicitis was interesting. I didn't communicate well enough about the pain, rating it as 4/10 because of how I'd interpreted '10' as the 'worst pain you can imagine'. Nowadays and even pretty soon after that I'd say 'bad enough I can't do x' or similar.

So worth looking at how well your teenager is communicating with the staff and intervening if they're trying to use childish face/pain scales or similar that doesn't match his intellectual functioning.

I was given pethidine and nobody told me it would make me sleepy. I was pretty cross about that as it happened when I was finally feeling awake from the general anaesthetic. (Also, yes I now know to ask about side effects).

Pain relief was a mixture of pethidine, paracetamol and ibuprofen.

I think with children there is a generalised attitude that they don't experience pain the same way adults do, will 'bounce back' and get over it, or will quickly forget about it. It's all wrong, it's as if children aren't considered to be full people. It's not all staff, of course, but enough that it's a problem.

One of my DC needed a lumbar puncture at six months of age. No pain relief, was literally pinned to a bed by two members of stAff while a third did the puncture. DC shrieked the entire time and then just went absolutely silent staring into space for around an hour after, clearly traumatised.

Other DC needed surgery. At pre-op, surgeon agreed due to DC being nervous that they'd have a pre-med for relaxation and no cannulas sited until after they'd had the gas. DC has neurological disability and surgeon wanted it all to be as calm as possible so as not to cause distress. Day of the op, ward decide to prep them by fitting the cannula and got me to agree by saying that the op would be cancelled if they weren't allowed to do it. They refused to provide numbing cream or spray because "it's faster to just do it rather than draw the process out by waiting for them to work". When DC is frightened, they are amazingly strong and dextrous, imagine an octopus on meth. We ended up in a situation where DC had wriggled away from the two staff members and was attempting to climb over the head of the bed, had slapped the needle tray out of their hands, and was screaming. Surgeon walked in on her pre-op rounds and put a stop to it all. When DC came back the ward afterwards, nurse attempted a telling off for "the ridiculous fuss". I asked to move hospitals and made a formal complaint.

Same DC had their appendicitis written off as constipation and fussing right up until it burst.

I was told they only bring the medicine cabinet round every 4 hours, so it doesn’t matter where you are up to with yours (if transferred from another ward or just arriving), you end up having to fit in with the ward routine.
I waited hours for pain relief after surgery once on a normal ward.

Oooft that’s horrendous. I’m so sorry to keep trauma dumping, but my infant son had six attempted lumbar punctures (doctors couldn’t cite the needle) one after the other without any pain relief. Two doctors tried three times each and then my (two week old) son was placed back in my arms. A third doctor came along and insisted on trying and my son had to be prised out of my arms while they tried again. The lumbar puncture was essential for treatment, but that was one of the most traumatic experiences of our lives. Again, no pain relief in sight before, and after once he’d had the lumbar I was told to just breast feed him for pain relief. Argh!

(again, so sorry for trauma dumping. This has been quite therapeutic!!)

I recently had 8hrs of gynae surgery via keyhole and was given… paracetamol. They asked if I wanted cocodamol to take home and I said I had stronger painkillers at home!
luckily I was fine and after the first couple of paracetamol I didn’t need any pain relief

Just to add - after I spoke with nursing staff about her levels of distress and the plan they had sent us home with, they were quick to alternate meds thereafter.

I agree. We were in hospital recently following a tonsillectomy - an admission due to bleeding and my wee one was in so much pain.

When we were initially discharged we were told how important it was to stay on top of her pain. We were prescribed paracetamol, ibuprofen and morphine, which tbh I hadn’t expected.

Then when we got readmitted she waited TEN HOURS for paracetamol. DH was with her and asked multiple times. I really regret not bringing in our own when he called and told me - I was on my way but just assumed she would have had it by the time I arrived.

This.

I'm so sorry to hear this, OP, but completely unsurprised, unfortunately. Pain relief in the NHS is an absolute joke, completely overlooked and nobody cares about the suffering or trauma, it seems.

I would personally give your child the pain relief yourself if it's not forthcoming. I did this last year with DD when it didn't come, despite much chasing. They went bonkers, but they'd already confirmed it was ok to have it, so I told them they had a choice of bringing it on time, or I would give it. There wasn't a third option on offer, but they were welcome to take their pick of the two. Lo and behold, suddenly a doctor mysteriously appeared to write up the pain relief and it arrived reasonably on time thereafter. Appalling that I had to do that and I complained afterwards.

You really shouldn't have to advocate for your child like this, but do not feel ashamed of doing so.

I remember when now 14 year old DS2 was 10 days old and had heart surgery, he was on morphine for a day which was pretty much then reduced to calpol.
DS1 has a genetic condition (NF1) which causes benign growths on nerve endings and his leg pain was dismissed as growing pains for so long, until an MRI showed growths on nerve endings. He was eventually prescribed gabapentin with a referral to the pain clinic at the hospital.

Adult pain relief is also not great.
I was admitted with a severe kidney infection, given morphine in a and e, taken up to ward, slept couple hours and woke in pain at about 2am. I asked for some pain relief, told nothing written up and they would bleep drs to prescribe. Asked again after an hour, nothing. They actually didn't bleep at all (I requested a copy of my notes) and at 7am I was in agony and called my husband and he brought me in co-codamol from home. And then I got a telling off for taking un prescribed medicine - we told them I took it so there wasn't any risk of overdose.

Yes my DD had open abdominal surgery last year and was given only paracetamol. 15 years ago I had similar incision with a C-section and was given stacks of pain relief - codeine and diclofenac, I think.

I've often wondered about this. One of my DC broke his arm when he was two. It was bent like a banana. The doctor examined it and then very quickly forced it back into shape without any pain relief and I have often wondered if they would have done the same thing for an adult. It definitely hurt!

That’s way too much if they were giving each alternative two hours?! Every four hours I would imagine

(Also a paeds nurse!)

I got the same line about ‘learning to tolerate their distress’ when they tried for the 7th time to get bloods without first applying numbing cream ‘because newborns don’t process pain the same way’. That may be but they clearly DO feel pain!

I really don’t mean this to sound like I’m bashing the NHS. We were in hospital for a year and the people we saw were incredible, saving my child’s life over and over again, I truly cannot fault them and I cannot thank them enough, but there is definitely some work that can be done around pain management I think!

It’s the same for adults. Major abdominal surgery in absolute agony in the hours after offered a paracetamol.

THIS

I’ve just written a waffle about my post-CS experience with inadequate analgesia and the midwives not giving a flying fuck/any fucks at all

YANBU

The bit I can’t get past the bit in your post where you said you had a morphine syringe driver after your CS

When I had my first CS I’d be lucky if some paracetamol got chucked my way, midwives were SO stingy esp during the first 12-24 hours when post-op pain is an massive issue (for me anyhow). And they lost my drug chart for around 6 hours, so couldn’t me anything…thanks for nothing. And they all seemed to have a total empathy bypass

Apologies I digress, as you were…