What I learnt this week: As calm as you are, is as calm as she’ll be #WILTW

This is the 87th #WILTW

Pain is an interesting phenomenon. Last weekend I aggravated an old, but not particularly serious, back injury. I  came into work on Monday and hobbled around the department feeling pretty stupid as intermittently the spasms would go away and I would be completely pain free. Not quite sure what my colleagues made of me.

It is very easy to be judgemental about pain. Even with no medical training the inconsistencies between reported pain, and its actual physical manifestation, are obvious to spot. Conversely I have yet to treat a child who has had a very serious limb fracture who even moans about it. They tend to be extremely quiet; the only sign of severe pain is their frightened face.

Despite the prevalence of pain we are still relatively information poor on how best to treat it, especially in children. There was a time when open heart surgery in neonates was performed with minimal anaesthetic.  Public health doctor and avid information sharer Ash Paul posted a link from the Canadian Institute of Health Research this week. Published in September it describes an initiative to improve awareness of pain management strategies in children.

(click here if the video doesn’t automatically appear)

The techniques described in the video should not be new to any health care professional who deals with children. Parents though aren’t always aware of some of the easy things that can be done. Distraction is a very powerful technique and rather than feeling and looking anxious it is helpful to the treating team for the parent to engage with their child. One of our play specialists reinforces this important role by saying to parents:

As calm as you are, is as calm as she’ll be

(or he obviously)

Anxiety about your child often promotes supra-rational responses. Not irrational because you are rightly worried about your child but often the profusely bleeding finger or the large bump to the head provoke near hysteria. Children are never helped by seeing their parents crying more than they are. “As calm as you are, is as calm as she’ll be” is sound advice.

Scared Child







It is also sound advice for health care professionals. No one likes someone who panics, especially in emergency care. In fact it is pretty sound advice generally. Start ranting at a meeting and it’s likely you will start getting other people raising their voices as well. Get frustrated with someone you are referring a patient to and they will get frustrated to.

As calm as you are, is as calm as they’ll be

What did you learn this week? #WILTW

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