Until comparatively recently, children too young to verbalize were also considered too young to experience pain or fear, and they often received no analgesia, even after major surgery.
However, it is now known that even neonates show a physiologic response to painful stimuli.
By relieving pain, the emergency provider can render the patient less anxious and more cooperative, thereby potentially achieving a better outcome.
Failure to cooperate is likely to result in a suboptimal outcome.
Pain in children historically has been underreported, undertreated, and misunderstood.
In addition, research has shown that children often do not receive the same treatment as adults with similar painful conditions.
Age is apparently a risk factor for oligoanalgesia.
Various individual internal and external factors determine how a child responds to painful procedures and thus affect the decision whether to premedicate the child.
Individualized dosing and titratable agents are often necessary.
The American College of Emergency Physicians (ACEP), the American Academy of Pediatrics (AAP), and the American Society of Anesthesiology (ASA) have all established guidelines.
Consequently, a potential for different practice models exists.
The need for written consent may be determined by an institutional, local, or state mandate.
Children of all ages should be NPO for clear liquids 2 hours before undergoing sedation.
Reasons for inadequate treatment include failure to recognize pain, ignorance about drugs and dosages, fear of adverse cardiovascular effects, and fear of delay in treatment and disposition. Conscious sedation (in which the patient remains awake) may lead to deep sedation.