A program at Alberta Children’s Hospital aimed at reducing and managing pain more effectively while children are receiving care in the Emergency Department is proving to be a success and plans are now underway to expand the initiative to other areas.

The Commitment to Comfort program was launched last fall and the goal is to make children more comfortable while they are being treated in the emergency room.

Two emergency doctors looked into what they could do to better manage pain and found that about 15 percent of children they talked to said they would have taken pain medication in the emergency department if it had been offered.

The physicians also discovered that 18 percent of children felt their pain was not being managed effectively.

“Treating pain is one of our highest priorities. It’s also important to the patients and families we see in the emergency department,” said Dr. Jennifer Thull-Freedman, ACH ED physician. “This initiative works to educate our families about the options available to them, as well as provide pain-management options to every patient who walks through our doors.”

Dr. Thull-Freedman says some of the patients they consulted with said they turned down pain medicine because they thought they would have to get a needle and in some other instances, parents were reluctant to accept medication before being seen by a physician.

Comfort menus that show the types of pain-management options available have been posted in the emergency department to promote the campaign and include things like needle-free pain medications, ice packs, warm blankets, light wands and tablets.

“We’ve collected feedback from over 500 patients and their families,” said ED physician Dr.  Antonia Stang. “Only five percent are telling us they would have wanted pain medicine but didn’t get it and families dissatisfied with their pain care has decreased from 15 percent to five percent. We’re working towards having 100 percent of our patients satisfied with how their pain was managed in the ED.”

To help them describe their pain, the young patients are also being given individual, bookmark-sized pain scales, which will assist staff to more accurately understand the level of each patient’s pain.

Madison Hilderman’s mother took her to ACH after she woke up with shoulder pain and she was given Tylenol while she waited for treatment.

“They were really good about asking me about what my pain was, like they asked me multiple times, which was good because, like my pain kind of kept changing a little bit, because this morning it was a lot higher, and it kind of goes back and forth in my shoulder now, but they’ve been really good about asking me a lot what my pain was,” she said. “It was easy for me because I looked at the chart and they have like the face there so I kind of looked at the chart, because I didn’t know what zero to ten would be so that was really good.”

Doctors and nurses have also received more education on how to support a child in pain.

“We have so many things to prioritize, we may not always notice the child who is experiencing his or her pain quietly,” said Thull-Freedman. “For example, comfort positions are promoted when a child needs a procedure, so he or she can sit up or snuggle a parent and feel in control, rather than having to lie flat.”

 Early feedback indicates that the program is working and plans are now being made to expand it into other areas of the hospital and other emergency departments in the city by late spring.