Safe and effective pharmacological management of acute and procedural pain in neonates, infants and early childhood requires understanding of age-related changes in both the pharmacokinetic and pharmacodynamic profile of analgesics. Evidence based clinical practice guidelines incorporate both pharmacological and non-pharmacological techniques that can have complementary roles in acute pain management. The knowledge, skills, and attitudes of paediatric pain physicians must be appropriate to the developmental stage and clinical state of the patient and also encompass the role of parents and/or carers.
The Faculty of Pain Medicine of the Royal College of Anaesthetists is concerned with the professional standards of Pain Medicine specialists, so this document focuses on the Pain Medicine specialist’s contribution to Paediatric Pain Medicine (PPM).
This document describes two levels of involvement in the practice of PPM:
• The first level outlines the core knowledge, skills and attitudes for all anaesthetists specialising in Pain Medicine who may need to be involved with this area e.g. making timely and appropriate referrals for paediatric pain management and emergency management of a child with pain. Whilst it is recognised that not all Pain Medicine specialists will be directly involved in providing a paediatric pain service, all need to have an understanding of this area.
• The second level outlines the advanced knowledge, skills and attitudes required of Pain Medicine specialists who work in teams providing a paediatric pain service. These competencies reflect those of the paediatric pain module which is an option at Advanced level of Pain Medicine training of the Royal College of Anaesthetists’ CCT in Anaesthetics curriculum, which sets out competencies for trainees who elect to take a deeper interest in this area of Pain Medicine practice