OTTAWA, ONTARIO – The Health Standards Organization has issued new rules to help hospital employees manage the pain of children, particularly those who are unable to speak when they are harmed.
It is the world’s first national standard focusing on paediatric pain.
Dr. Samina Ali, an emergency physician and paediatric pain researcher, explains that for a long time, clinicians assumed that young children’s neurological systems were so immature that they couldn’t sense or recall pain.
“Babies were having open heart surgery without anaesthetic in the mid-’80s,” said Ali, who is also a professor of paediatrics and an adjunct professor of emergency medicine at the University of Alberta.
“Even if those children don’t have the words at the time, their bodies remember, and we observe the long-term effects in their physical and psychological development.”
Since then, the government has made significant progress in managing the pain of young children, and standardising the method throughout the country is another significant step, she said during a technical briefing on Monday morning.
According to Katie Birnie, a psychologist and associate scientific director for Solutions for Kids in Pain, children in hospitals have an average of six unpleasant operations every day.
For newborns in critical care, the figure is closer to 14.
The new requirements include requiring incident reporting when a patient experiences avoidable, untreated, and uncontrolled pain as one of 34 criteria for staying on top of pain management for young patients.
The criteria also advocate for continual training for health-care personnel, as well as ensuring that each patient’s pain and treatment effectiveness are constantly reviewed.
The recommendations will be made accessible to hospitals and health workers for free by Accreditation Canada and the Health Standards Organization, with the intention that they would one day form the basis of policy and training for health-care providers.
Dr. Justina Marianayagam, a paediatric resident at B.C. Children’s Hospital in Vancouver, recalls one hour-long lecture on pain management throughout her four years of training.
“From a training aspect, there’s a great demand,” said Marianayagam, who suffered from severe pain as a youngster.
According to Birnie, one out of every five youngsters suffers from chronic discomfort.
“That puts kids at a higher risk for mental health problems, drug abuse, and socioeconomic inequities in adulthood,” she says. Pain can also have an impact on a child’s emotions, friendships, family ties, sleep, and physical function.
Children who are Black, Indigenous, or otherwise face prejudice and unfairness suffer disproportionately, she claims.
“We know that in North America, Black children are less likely than white children to obtain pain care,” Ali noted, even for traumas like broken limbs and appendicitis.
As a result, the new recommendations encourage institutions to review and evaluate the equality of their paediatric pain management services.
The newly released criteria are the result of a 2021 action plan for Health Canada by the Canadian Pain Task Group, which advocated for a more standardised approach to pain treatment throughout the country.
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