Online Pediatric Pain Management CME Resources

June 9, 2011

These online CME modules provide useful information that can be applied in the clinical setting to improve outcomes in pediatric pain management.

Physician lack of awareness, expertise, and experience with assessing and treating pain in children and adolescents has been identified as a key contributing factor in the widespread undertreatment of pain in this population. The online CME modules described below provide useful information and training that can be applied in the clinical setting to improve patient care.

Pharmacological Treatment of Acute Pediatric Pain

This course reviews multiple etiologies of acute pain, the use of various pain assessment scales in the clinical pediatric setting, and the selection of appropriate therapeutic modalities for the treatment of acute pain in children, with special attention paid to the risks associated with each intervention.

Assessment and Diagnosis of Pediatric Pain

Michelle Fourtier, PhD, reviews “the prevalence and theories” of pediatric pain and discusses the evidence-based assessment of acute and chronic pain in children. She provides examples from the current literature on the prevalence of children’s pain, reviews evidence-based assessment tools for acute pediatric pain, and outlines several assessment strategies for chronic pain in children.

Pediatric Pain Management

This text-based activity from the AMA describes “developmentally appropriate strategies and tools for assessing pain in children” and outlines several pharmacologic and nonpharmacologic pain treatment options. The authors identify several misconceptions about the nature of the pain experience for children that can potentially lead to pain being underrecognized and undertreated in this population. This unrelieved pain “can lead to considerable anxiety and distress and, in some instances, can have long-term physiological and behavioral consequences” for the child. The course reviews the use of both self-report and observational pain scales for the diagnosis and assessment of pain in children and adolescents. Treatment-related topics covered in this activity include:

  • Newborn physiology and its effects on the pharmacology of opioids and local anesthetics
  • Acetaminophen and non-steroidal anti-inflammatories dosing
  • Pharmacokinetic differences between neonates and older children that should inform opioid dosing decisions
  • The advantages and disadvantages of several opioid formulations (oral, intravenous, and continuous infusions)
  • Key concerns in the use of patient-controlled analgesia
  • Local and regional anesthesia options for pain management
  • Persistent pain in children

The activity summary reminds physicians that “appropriate pain management services should be available for children with chronic or recurrent pain associated with medical disease or injury,” including “all of the current modalities for treating pain in adults, as well as sedation or anesthesia for invasive procedures.” Clinicians should pursue a multimodal, multidisciplinary approach to pediatric pain management where possible, involve families in the decision-making process, and tailor pain management plans and interventions to the individual needs of the child.

Pediatric Pain Management

Available for download in PDF and MP3 audio format, this activity from Pediatric UPDATE is based on a roundtable discussion involving three experts in pediatric pain management. The participants discussed secondary problems that may develop in children with chronic pain; appropriate responses to fear and anxiety in pediatric patients with acute and chronic pain; effective management of postoperative pain in children; the use of antidepressants, anticonvulsants, and other adjuvant medications; the incorporation of self-hypnosis and other mind/body techniques and integrative approaches in the management of pain in children; and strategies for the multidisciplinary management of complex chronic pain in children.

Musculoskeletal Pain Syndromes in Children

Also available from Pediatric UPDATE, this course reviews strategies for assessing, diagnosing, and treating chronic musculoskeletal pain in children and adolescents. The roundtable participants discussed diagnostic approaches for pain amplification syndromes and how to identify the “characteristic biopsychosocial profile of the patient with a pain amplification syndrome.” They also reviewed the clinical features of reflex sympathetic dystrophy, fibromyalgia, and hypermobility syndromes.

Disparities in Care: Special Populations in Pain Management

Part of the American Academy of Family Physicians “Management of Chronic Pain” series, this activity focuses on the various patient characteristics that can have an impact on the perception and expression of pain. The information offered in this course provides insight into “how age, gender and ethnicity impact the diagnosis and management of pain and discuss specific tools and strategies to facilitate pain management in these patient populations.” Module 1 covers chronic pain management in children, explaining that clinicians should be aware of the ways in which children’s perception, experience, and expression of pain and response to treatment differs from that of adults, and outlining several strategies and approaches for improving pain management in this population.