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September 17, 2013

Music can distract kids from the pain of medical procedures

(Continued)

Other useful techniques include storytelling, guided imagery (talking to kids about a special place or event), blowing soap bubbles and, not surprisingly, tablet games. Sipping sugar water, sitting in parents' laps and deep breathing can also help mitigate children's pain in the doctor's office or the emergency room.

Such distractions might require a rethinking of the doctor visit. For years the protocol in many pediatric practices has been to give out stickers or candy after kids get their shots. "Why not put something in place before the injection?" asks Denise Harrison, a nurse and researcher at the University of Ottawa.

In a 2010 study, Harrison found that in 13 of 14 clinical trials, use of a sugar solution — typically given orally two minutes before an injection — reduced babies' crying upon getting the shot.

Harrison and William Zempsky, head of pain medicine at Connecticut Children's Medical Center, are part of a group of physicians and researchers trying to change the way health-care providers manage pain in children. They have compiled evidence for sugar solutions and other approaches such as a skin spray, Pain Ease, that produces a freezing sensation, and a patch that numbs the skin before the shot. Zempsky co-authored a clinical report for the American Academy of Pediatrics that offered pain-reducing strategies for immunizations, including the use of sugar solutions.

In the ER, sometimes kids need strong pain medications, but there's a reluctance to give such drugs to children, especially very young ones. "Studies show that kids under 2 years don't get appropriate pain meds," Zempsky says, noting that physicians and parents are fearful of giving them opiate drugs such as morphine. "But these drugs are safe and effective and appropriate to use," he says, especially with painful injuries such as a fracture or a scald burn.

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