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The World in Medicine
November 10, 1999

Diagnosing Pediatric Pain

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JAMA. 1999;282(18):1713. doi:10.1001/jama.282.18.1713-JWM90009-2-1

A new method of evaluating pain in children up to age 4 years is set to be implemented in 60 hospitals in the Netherlands.

The Pain Observation Scale for Young Children, called POCIS, measures pain levels according to children's behavior in seven categories: facial expressions, crying, breathing, torso movements, movements in the arms and fingers and in the legs and toes, and restlessness. Physicians and nurses observe the intensity of these behaviors and calculate a pain severity score ranging from 0 to 7. Researchers from the University of Amsterdam who developed the scale said that existing behavioral pain measures were created for premature neonates or infants and may not be appropriate for older children. Some of those measures are upsetting for children because they require restraint or physical contact by a health care professional. The scale was shown to be reliable and easy to use in a recent study of 311 children who had undergone adenotonsillectomy, adenotomy, or insertion of ventilation tubes. Observation and scoring can be completed in less than 2 minutes, the authors reported. The study appeared in the August issue of the Journal of Developmental and Behavioral Pediatrics.

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