One of the most challenging parts of pediatrics jobs is pain management and assessment of pain in infants and other very young children. While most adults are perfectly capable of explaining the pain they feel or rating it on a scale, infants are unable to speak, and young toddlers may not fully understand how to rate their pain or verbally express it. Studies have suggested that infants are often under-treated with opioid pain medicines or other analgesics out of concern for potential effects on heart rate or breathing, despite few instances where this actually becomes a problem.

Assessment of pain is itself a challenge for pediatricians and pain management physicians that work with infants. Where the adult pain scale cannot be used, a pain scale chart is often relied upon. Pain scale charts often show a series of faces, with the infants’ expressions and reactions being used to gauge their response level and show indications of discomfort or distress. For most children, acute or severe pain is due to injury or to an invasive procedure such as surgery.

In outpatient settings, most treatment for pain is handled by using nonsteroidal anti-inflammatory drugs (NSAIDs). Most parents recognize these types of medicines, such as acetaminophen (Tylenol). In clinical settings, acetaminophen poses little risk, and it can be administered either orally or rectally. Depending on the particular infant in question and the pain management needs being met, other NSAIDs like naproxen or ibuprofen can also be administered orally or rectally, and dosage can be continually monitored or administered. For severe pain such as that which occurs post-operatively, oral opioids can be added for short-term use. Surprisingly, these can include drugs like oxycodone, hydrocodone, and codeine.

The least recommended drug for infants is codeine, mainly because it is metabolized to morphine via the cytochrome P-450 2D4 isoenzyme. Some individuals (1-2% of Asians and 5-10% of Caucasians) are poor metabolizers of the drug due to a genetic polymorphism. For the unfortunate individuals with this genetic condition, codeine has little effect, if any. Thus for an infant who cannot speak or communicate, it’s important to make sure that the pain medicine is working appropriately. At the same time, a very small number of individuals (mostly from East Africa) have a genetic predisposition that makes them “ultra-rapid” metabolizers – meaning their bodies convert a larger than normal amount of codeine into morphine; this means they can experience toxicity and suffer severe harm. The genetic variations amongst patients is therefore why codeine is normally the last choice for infant pain management.

For parents who may fear pain management methods for their infants and children, addiction should not generally be a concern. Pediatric patients are less likely to suffer the compulsive use of opioids that adults often struggle with. For one thing, pediatric patients will not be in control of their own usage, since a parent or a physician will always be providing and administering the medication. Furthermore, infants and small children are likely to need pain management for different conditions than adults might. As always, parents should feel confident speaking with a qualified pain-management physician, a pediatrician, or a trusted family practice doctor about the medication or procedures that their children will receive beforehand. In the past, children’s pain was not always recognized or treated appropriately, yet today, parents and children have more options than ever to make sure that surgical procedures are not unduly stressful and that accidents and injuries do not cause disturbing amounts of discomfort.

To learn more about great pediatrics jobs, visit PhysEmp.com or call 800-267-6115. You can search and apply to more than 25,000 listings, including family practice jobs, hospitalist jobs, general surgery jobs, ObGyn jobs, and more

To learn more about great pediatrics jobs, visit http://PhysEmp.com or call 800-267-6115. You can search and apply to more than 25,000 listings, including family practice jobs, hospitalist jobs, general surgery jobs, ObGyn jobs, and more.

Author Bio: To learn more about great pediatrics jobs, visit PhysEmp.com or call 800-267-6115. You can search and apply to more than 25,000 listings, including family practice jobs, hospitalist jobs, general surgery jobs, ObGyn jobs, and more

Category: Parenting
Keywords: pediatrics jobs, ObGyn jobs, pain management jobs, infant pain, pediatric pain management,