Multidimensional Assessment Self report/parent report Intensity Quality Pattern Aggravating / alleviating factors Medication history Meaning

Assessment Behavioral assessment Physiologic assessment Proxy report Use of scales Involve family Never dismiss a child’s report of pain based on observed behavior Physiologic assessment Proxy report

Reassessment of Pain Changes in pain Changes in analgesic regimen Assess consistently Use of diaries

Neurologically Impaired Assessment Child may have limited self report Parent interview Pain behaviors Interventions Non-pharmacological Pharmacological References/Resources: Walco, Goldschneider, & Berde, 2008; Oberlander & Symons, 2006 Oberlander & Symons, 2006; Walco & Goldschneider, 2008

Neonatal Pain Assessment Tools CRIES Neonatal Postoperative Pain Measurement Score Krechel & Bildner, 1995 Premature Infant Pain Profile (PIPP) Stevens et al., 1996 Neonatal Infant Pain Scale (NIPS) Lawrence et al., 1993 Neonatal Pain Agitation and Sedation Scale (NPASS) Hummel & Puchalski, 2001

Pain Assessment Tools Pre-verbal / nonverbal (examples) FLACC Pain Observation Scale Modified Objective Pain Score Non Communicating Children's Pain Checklist (NCCPC)

Univariate Pain Intensity Scales FACES, OUCHER VAS (Visual Analog Scale) Verbal Report Scale

Multivariate Tools Initial Pain Assessment Tool Brief Pain Inventory Parent / Child Total Quality Pain Instruments Neuropathy Pain Scale Adolescent Pediatric Pain Tool

Communicating Assessment Document clearly in chart Assessment Intervention Re-assessment Establish Pain Care Plans