GOLD Learning Speakers

Neonates admitted to the Neonatal Intensive Care Unit (NICU) undergo numerous painful procedures each day, with fewer than one-third receiving analgesia. This is alarming as neonates who are critically ill and in pain are susceptible to developing life-threatening complications, since they cannot maintain homeostasis in a state of stress. Additionally, the cumulative effects of these painful experiences, has significant negative consequences to the neurodevelopment of these vulnerable neonates. Pain assessment is fundamental to effective pain management although there is currently no universally accepted scale for pain assessment in neonates, and more evidence is required to determine the reliability and validity of existing pain assessment tools. Additionally, health clinicians do not know if the physiological and behavioural indicators of pain they observe are specific to pain, or a manifestation of the neonates medical condition, disease process, agitation, distress, fear, stress or even sadness. This issue is compounded when the expressive capacity of critically ill neonates is compromised by the administration of heavy sedation and muscle-relaxants. This presentation explores some of the complexities of pain assessment in neonates followed by practical advice for the health clinician, including a look at the modified Pain Assessment Tool (mPAT) and how it can help improve neonatal pain assessment in the clinical setting.