Alleviating pain a key priority at The Montreal Children's Hospital of the MUHC

Acute Pain Service expands once again

The Montreal Children's Hospital of the McGill University Health Centre (MUHC) expands its Acute Pain Service to help alleviate the discomfort children suffer after surgery or due to some medical diseases such as sickle cell anaemia. In the last three years, thanks exclusively to private funding, The Children's has revolutionized its pain service. It has recruited and trained a team of anaesthesiologists, nurses, pharmacists, residents, physiotherapists and child life experts who provide pain relief 24 hours a day, seven days a week to infants, children and adolescents. Few hospitals are able to provide this type of around the clock relief for acute pain. In addition, The Children's has purchased 14 programmable pain pumps and pain monitors that make the delivery of pain medication safe, timely and efficient.

"The Children's boasts one of the best acute pain services in Canada, " says Dr. Etienne Goujard, an anaesthesiologist at The Children's, who was recruited from Paris three years ago to head the Acute Pain Service. "We didn't want to be the cowboys of pain control. We have developed this service slowly and thoroughly. There are a lot of potential complications."

"Parents are clearly relieved to know that all efforts are being taken to assess and treat their children's pain" says Annik Otis, clinical nurse specialist in the Acute Pain Service. "And its is much better for children because when pain is minimized or eliminated, children tend to sleep better and heal faster and thus spend less time in an intensive care unit (ICU) and less time in the hospital all-together. Top notch pain relief also alleviates a child's stress and anxiety and other psychological discomforts."

The Children's is also one of a few hospitals in Canada to have nurse controlled analgesia. This type of pain relief is used on babies and very young children as well as on children with arthritis. The nurse is able to administer a dose of medication every 10 minutes rather than the traditional time lapse of once an hour. This allows fast acting pain medication to be administered which alleviates pain faster and keeps it at bay more effectively.

Since 2000, The Children's has invested a total of $500,000 into its Acute Pain Service. This was made possible thanks solely to generous donations to The Montreal Children's Hospital. The Children's has used these private donations to purchase pain pumps and monitors and today ten new monitors are being added to the fleet. Because of the diverse range of patients treated (premature babies, infants, children and adolescents), The Children's purchased top quality pain pumps and monitors which can be up-graded ensuring years of use. The monitors measure a child's vital signs such as blood pressure, heartbeat, respiratory rate allowing nurses to administer pain medication precisely when the discomfort begins.

There are two types of pain pumps.

• Regional pumps that administer analalgesia via the epidural space.
• Patient Controlled Analgesia (P.C.A) allow children ages six and up to push a button to deliver a dose of pain medication whenever they feel it is necessary.

In coming years, The Children's will continue expanding its Acute Pain Service by continuing to train personnel on how to alleviate acute pain; by developing new acute pain programs for each pathology rated at The Children's; by working with the MUHC adult sites to ensure the easy transition of patients with acute pain from the pediatric to adult care; by conducing research to find new and better ways of alleviating acute pain.

In addition to the Acute Pain Service, The Children's has an equally impressive Chronic Pain Service that helps children with such ailments as rheumatoid arthritis, migraines and pain associated with skeletal abnormalities.

The Montreal Children's Hospital is the pediatric teaching hospital of the McGill University Health Centre. This institution is a leader in the care and treatment of sick infants, children, and adolescents from across Quebec. The Montreal Children's Hospital provides a high level and broad scope of health care services, and provides ultra specialized care in five areas of expertise: cardiology and cardiac surgery; neurology, traumatology and neurosurgery; genetic research; musculoskeletal conditions, including orthopedics and rheumatology; psychiatry and child development. Fully bilingual and multicultural, the institution respectfully serves an increasingly diverse community in more than 50 languages.