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Original poster

Pediatric pain in hospitals - undertreated?

36 replies

Laffydaffy · 25/06/2025 18:39

Currently in hospital with a teen. Just started a new treatment for ataxia (movement disorder) and one of the side-effects for him is a severe headache, which he says he has never had so bad. The management of the headache has been extremely poor, and I remember something similar happening with my daughter last year, and I swore I would speak up if something similar happened. Just the administration of ibuprofen and paracetamol together has nurses saying it cannot be done, and that DS has to wait four more hours, while his pain stays at an 8. I am a paed nurse, and darn it, there is nothing wrong for a combination of the two, especially when a child's pain is not well controlled.

Why is pain-management for children still such a problem? I know as adults, that when we have pain that is not controlled, we seek help. I take paracetamol and ibuprofen together if I need it, with caffeine tablets for extra help for severe headaches (not migraines). I remember kids after their tonsillectomies weeping in pain and being forced to swallow pain relief every few hours with raw, open wounds and a cannula in the arm that was still available to use for pain relief. And then I remember the midwife apologizing to me after my emergency caesarean for being a bit late with my morphine syringe-driver.

Has anyone else experienced this?

OP posts:
Castlereagh · 25/06/2025 20:04

Yes absolutely agree, my child has morphine immediately after brain and spine surgery, 24 hours later they were just giving paracetamol. When they were trying physio that day DC cried with the pain. The physio asked if DC was easily upset/distressed. Well, no you've just cut open their head, skull, brain and removed a vertebra and all you eejits are giving them is what they had for teething pain when they were babies, bloody Calpol. When I said this I got stern words from the doctor about learning to tolerate my child's distress.

nocoolnamesleft · 25/06/2025 20:01

It's definitely got harder to optimise pain relief in younger children since codeine got banned in under 12s, because it's seen as such a big step up between paracetamol/ibuprofen and morphine.

Shuntsarentscary · 25/06/2025 19:58

Laffydaffy · 25/06/2025 19:35

And this made me so sad. Your poor little fellow. How is he now? I remember a similar situation of a little baby after meningitis, and the night the right pain relief was given.

Show quote history

He’s doing absolutely brilliantly now, thank you so much for asking ❤️ after a horrific year where we nearly lost him on several occasions, he had his last shunt in at 15 months and he’s now almost five, been hospital free since then! Was slow to walk and talk, and definitely has mild delay (presents more like a 4 year old) but he is the most gorgeous, joyous, sweet natured, chatty and funny wee soul. He is so resilient and determined, and is honestly pure sunshine! I hope your poor boy is feeling better soon, there is nothing worse than feeling so helpless and watching them fight illness 😢 xxx

Needanadultgapyear · 25/06/2025 19:58

It took me telling a consultant that if I as a veterinary surgeon left a dog in the level of pain that my daughter was in I would be considered negligent - he grudgingly prescribed an relief because I insisted.

Parrotdrill · 25/06/2025 19:58

So sorry your child is suffering.

I think it is nhs hospitals in general .

Totally. understaffed and so even when people are screaming in pain (post operatively etc) you are ignored…

had a totally better experience in private hospital where pain management was taken very seriously and in a specialist nhs hospital where it was run far more like a private one …

but standard nhs wards in my opinions are just so overrun and so short staffed that pain is often just totally overlooked.

have spent a lot of time in hospitals having a lot of major surgeries and very rarely was pain managed well and often even when you asked politely and calmly they would leave you for hours as no dr available to ‘write it up’

Mayflyoff · 25/06/2025 19:49

The thing I find surprising in your OP is that you've experienced adults getting adequate pain relief.

Original poster
Laffydaffy · 25/06/2025 19:35

Shuntsarentscary · 25/06/2025 18:57

I agree with you completely. The way my baby was just left with nothing but brufen after multiple brain surgeries/ cannulas/ blood clots/ sepsis/ meningitis etc. it was horrifying how it was literally calpol that he was offered. One night on the ward he cried and cried and cried for hours and then FINALLY got a dose of oramorph and the relief through his little body was heartbreaking to see, why wasn’t it standard pain management practice? I got codeine and tramadol after my tonsillectomy aged 21!!!

And this made me so sad. Your poor little fellow. How is he now? I remember a similar situation of a little baby after meningitis, and the night the right pain relief was given.

OP posts:
Original poster
Laffydaffy · 25/06/2025 19:31

Hankunamatata · 25/06/2025 19:07

Not my experience with kids. The regime was very good alternating paracetamol and ibuprofen (unless broken bone) every 2 hours alternatively. Ketamine as soon as administered to a&e if severe pain.
Dc recently had tonsillectomy and pain relief was kept well on top of with strict warnings to keep regime up at home

Gosh, that makes me so happy to read. I cannot tell you how much. We also had a strict protocol of alternating pain relief in paeds in Australia (mother country) with an obviously maximum daily dose. In the hospital in the European country I live, they give an alternating dose of ibuprofen and paracetamol every 4 hours. I have begged for it to be given earlier, the doctors say yes, yes, and write nothing, which means the nurses follow the 4 hour scheduling. The thing is, you know pretty quickly when ibuprofen will work or not. It is such a horrible, horrible feeling, waiting the pain out, and not knowing if the next dose will be enough.

OP posts:
Hankunamatata · 25/06/2025 19:07

Not my experience with kids. The regime was very good alternating paracetamol and ibuprofen (unless broken bone) every 2 hours alternatively. Ketamine as soon as administered to a&e if severe pain.
Dc recently had tonsillectomy and pain relief was kept well on top of with strict warnings to keep regime up at home

Shuntsarentscary · 25/06/2025 18:57

I agree with you completely. The way my baby was just left with nothing but brufen after multiple brain surgeries/ cannulas/ blood clots/ sepsis/ meningitis etc. it was horrifying how it was literally calpol that he was offered. One night on the ward he cried and cried and cried for hours and then FINALLY got a dose of oramorph and the relief through his little body was heartbreaking to see, why wasn’t it standard pain management practice? I got codeine and tramadol after my tonsillectomy aged 21!!!

alexalisten · 25/06/2025 18:44

It like this on adult wards to. Iv waited hours multiple times in hospital for pain relief. Everytime you ask a nurse something they forget the second they walk out of the door then you feel like your being annoying when you keep asking.