Paediatric Pearls

We currently use 2 recognised pain scores in our Emergency Department, depending on the age of the patient.  The FLACC score (ref) was put together at the end of the 1990′s and has been validated for use in pre-verbal children aged 2 months to 7 years.  The Wong Baker (“smiley faces”) score is for use in the over 3′s.  We also ask older children to give us a mark out of 10 on their pain with 10 being the worst they have ever felt and 1 being not too bad.  Our local pain protocol suggests what the health professional should do with the information gleaned and when the child should be reassessed.  I have reproduced that table for you here.  The UK Department of Health National Service Framework for young people and maternity services says that the prevention, assessment and control of pain in children should be subject to regular audit.

Well the BMJ produces 2 journals in one in August so why can’t I?  All the topics featured this month are relevant for both GPs and ED doctors – for once – so you have a joint newsletter.  I have covered headache this month, Vitamin D (by popular request) and we have started the “Feeding” series requested by my ED senior colleagues.  It seems appropriate to have covered breastfeeding first.  Do leave comments below.

I featured a headache guideline from Great Ormond Street Hospital in August 2011′s Paediatric Pearls. My colleague, Dr Simon Whitmarsh, has kindly allowed me to upload his migraine headache patient/parent information leaflet which I hope you and your patients will find useful. Please ensure that, as a courtesy, you acknowledge it as Simon’s work when you use it.