Learning Objectives
- Identify the elements of a focused clinical history that are needed to assess a developmentally disabled pediatric patient who appears to be experiencing pain.
- Describe the methods for assessment of pain in a non-verbal child, and how to choose the method most useful for assessment of a particular patient.
- Explain the differential diagnosis of presumed pain in a developmentally disabled, nonverbal child and strategies for defining the etiology.
- Describe the environment of the patient, including the home and school, with special focus on the caregiver team and its management of medications or other treatments for the patient.
- Discuss the interpersonal, developmental, emotional and social consequences of the pain experienced by this patient, and techniques to elicit relevant information about these from the parent.
- Explain the pathogenesis of pain associated with hip dislocation, and other sources of pain, in a developmentally disabled child who cannot sit, stand, or walk.
- Describe the potential strategies for management of pain in this child—surgery, pharmacology, complementary medicine, physical therapy, occupational therapy, and behavioral strategies—and possible contraindications of these approaches.
- Communicate one’s knowledge and opinions to the entire patient care team with confidence, clarity and respect, working to ensure common understanding of the patient’s needs and care decisions.
- Describe the Patient Centered Medical Home in the context of current problems with the US health care system that are relevant to pain in a non-verbal pediatric patient, including specific tools and methods that might be used to meet the Triple Aim of better healthcare, lower cost of healthcare and improved patient outcomes.
Goal
All learners will be able to describe the principles of evaluation and conservative management of pediatric pain in a developmentally-delayed child.
Target Audiences
- Medical students: 3rd year
- Medical residents: 1 – 3 year
- Dental students: 1 – 4 year
- Pharmacy students: Pharmacy curriculum and clinical rotations
- Nursing students: Clinical rotations
