{
  "abstract": "The relief of pain and anxiety associated with painful or invasive procedures is a top priority in paediatrics. A ‘Sounding Board’ in the New England Journal of Medicine 30 years ago stated that ‘The assessment and treatment of pain in children are important parts of Paediatric practice, and failure to provide adequate control of pain amounts to substandard and unethical medical practice’.1 As we move into the second quarter of the 21st century, has procedural pain management for children in emergency settings improved? We can probably say that it has. In the USA, procedural sedation and analgesia have now become a core clinical competency of paediatric emergency medicine fellowship training mandated by both the Accreditation Council for Graduate Medical Education and the American Board of Pediatrics. In the UK, the Intercollegiate Guidelines on Standards for Children and Young People in Emergency Care Settings specifically emphasise the need to address processes related to procedural analgesia and sedation, especially during fracture manipulation in children. The UK and other countries have recognised that failure to implement evidence-based pain prevention and treatment for children in medical facilities is now considered a poor standard of care. However, it is vital that clinicians, organisations and regulators constantly challenge their practice as there is still significant progress to be made. A systematic review reported widespread undertreatment of procedural pain in neonates and concluded that it is a concerning issue in neonatal care. The most frequent procedures were heel lance, suctioning, venipuncture and insertion of peripheral venous catheters. Pharmacological and non-pharmacological pain management approaches were inconsistently applied.2 A study on children with cognitive impairment suggests that these children often endure greater pain and anxiety during needle-related procedures than their typically developing peers. Notably, more than 50% of the children in this study underwent over 30 venipunctures in their lifetime.3",
  "authors": [
    {
      "affiliations": [
        "Division of Paediatrics, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel"
      ],
      "name": "Itai Shavit"
    },
    {
      "affiliations": [
        "Institute for Maternal and Child Health-IRCCS 'Burlo Garofolo, Trieste, Italy"
      ],
      "name": "Egidio Barbi"
    },
    {
      "affiliations": [
        "Health Sciences, University of Leicester, Leicester, UK",
        "Paediatric Emergency Medicine Leicester Academic (PEMLA) Group, University Hospitals of Leicester NHS Trust, Leicester, UK"
      ],
      "name": "Damian Roland"
    }
  ],
  "title": "Inequitable management of procedural pain in children: reduction of ileocolic intussusception as an example",
  "uid": "ebfb0f40-1884-5539-88d6-1883316c70fd"
}