Pain-free ER visits for kids may lead to less fear of doctors

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Being in an emergency room can cause a lot of anxiety, especially for children. A new report from the American Academy of Pediatrics recommends that managing pain and lowering stress might be able to make the visit less scary for the young folks while not affecting treatment.

"Parents should advocate for the children for pain and anxiety management," report author Dr. Joel Fein, an attending physician in the emergency department at the Children's Hospital of Philadelphia, said to HealthDay.

The report, which was published online on Oct. 29 in Pediatrics, recommends that pain relief should start as soon as possible, even in the ambulance before the child is admitted to the hospital.

The researchers discovered that although there have been improvements in treating children's pain, there were still many factors that prevented a completely pain-free experience. Doctors often fear that by treating children's pain, they may be subjecting them to adverse side effects or the pain medication may cover other problems, making it harder to make a correct diagnosis.

Narcotic use on children is still frowned on by many, the report noted. Topical anesthetics, or numbing medications that do not have to be ingested like some creams, are not available in all emergency departments.

But, the researchers found that medications like acetaminophen, ibuprofen, oral narcotics or topical analgesics can help relieve pain and do not alter a doctor's ability to make a correct and timely diagnosis.

Even giving sugar water may help reduce pain for the youngest infants, Fein pointed out. He and his team also advocated for the use of topical analgesics when using IV catheters in the report.

"Children have a pretty significant fear of needles," Fein said. "Topical anesthesia can offer pain protection during IV line placement and [drawing blood]."

Researchers also believe that keeping the child calm can help make the emergency room experience more pleasant. This includes giving the family a private room with colorful walls and pictures on the ceilings, and giving the child toys or games to keep them distracted. However, the most important component of keeping a child calm is to keep their parents calm. Even though there is no evidence that having parents around reduces pain, it has been shown that they can calm children down if they are near.

"Parents are often very anxious, recalling their own past ER experiences. It's important that we educate parents as well as the child," Dr. Hnin Khine, a pediatric emergency specialist at the Children's Hospital at Montefiore in New York City, told HealthDay. "They don't have to tell their children to be strong even though it may hurt. We have to let them know that we can do this pain-free now. It's a whole learning curve for all of us."

Dr. Michael Kim, chief of pediatric emergency medicine at the University of Wisconsin School of Medicine and Public Health, told ABC News that a better emergency room experience for children could lead to less fears of the medical system for them in the future.

"When kids are subjected to emotional distress due to painful procedures, there's evidence to suggest they can have lasting emotional scarring," said Kim, who was not involved with the new report. "That's why kids are scared of doctors. ... This could cause problems in seeking health care."

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