Certificates provided by accrediting body (23 Match)
American Nurses Credentialing Center
In support of improving patient care, Relias LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
California Board of Registered Nursing
District of Columbia Board of Nursing
District of Columbia Board of Nursing Approved Continuing Education program (CEBroker Provider #50-290).
Florida Board of Nursing
American Occupational Therapy Association
Relias LLC is an approved provider of continuing education for occupational therapists by the American Occupational Therapy Association. AOTA does not endorse specific course content, products, or clinical procedures.
Course approval ID# . This Distance Learning-Independent is offered at 0.1 CEUs Intermediate,Category 1 & 2.
Florida Board of Occupational Therapy
Alabama State Board of Occupational Therapy
Georgia Board of Nursing
Accreditation Council for Continuing Medical Education
South Carolina Board of Nursing
Florida Board of Medicine
West Virginia Board of Registered Nursing
New Mexico Board of Nursing
Arkansas State Board of Nursing
Ohio State Medical Board
Louisiana State Board of Medical Examiners
Mississippi State Board of Medical Licensure
Arizona Board of Occupational Therapy Examiners
Georgia State Board of Occupational Therapy
South Carolina Board of Occupational Therapy
Louisiana State Board Medical Examiners- Occupational Therapy
Mississippi State Department of Health- Occupational Therapy
Tennessee Board of Occupational Therapy
Misconceptions and Myths
Through a Child’s Eyes
Cognitive Abilities of Children Related to Pain
Display physiological and facial signs of pain
Have a pain memory
By 12 to 17 months, 45% have one word to express pain
By 18 to 23 months, 81% now have one word to express pain
Simple words for pain (“owie”). Toddlers less than 30 months tended to say “ow” or “ouch”; those older than 30 months used more complex words, such as “hurt” or “sore”
Parental presence very important during painful procedures
Beginning sense of control/autonomy
Generally, can’t provide ratings for intensity of pain
Look to parents for their behavioral cues on how to react
Concrete language to express pain
Can point to pain location
By age 5 may be able to point to FACES pain scale to rate pain
By kindergarten can use more complex descriptors, such as burning or stabbing.
May not understand reason for painful procedure
May believe pain is a punishment
Have ability to fantasize and use imagination (magical thinking) which can be a tool to help decrease pain
Fear loss of body integrity
Band-Aid can be important
May try to delay interventions as a way to have sense of control
Self-report is more reliable indicator of pain location and intensity
By ages 7 to 11, can relate pain to an injury and have a begin to express emotional pain
Begin to understand reason for painful procedure, but fear loss of body integrity
Can better use own coping techniques for painful interventions
Feelings of embarrassment or loss of control may not allow them to express pain
Better able to use coping techniques for procedures, particularly with practice
Better understanding of the reason for the painful procedure
Able to link complex topics, such as pain and suffering
Beginnings of omnipotent feelings; may believe they cannot be harmed
Expressions of Pain
Age-Appropriate Assessment Tools
Preterm and Neonates: Behavioral Tools Are Needed
Neonatal Infant Pain Scale. NIPS evaluates facial expression, cry and breathing pattern, arms, legs, and state of arousal.
Premature Infant Pain Profile. PIPP evaluates gestational age, behavioral state, heart rate, oxygen saturation, eye squeeze, brow bulge and nasolabial furrow.
CRIES. This tool evaluates crying, oxygen saturation, heart rate, blood pressure, expression, sleeplessness.
Faces, Legs Activity, Cry, Consolability. FLACC evaluates children ages 3 months to 7 years. This behavior tool looks at the child’s general behavior to reach a total pain score from 0 to 10.
Children 3 Years and Older
OUCHER. This tool shows photos of faces from no hurt to biggest hurt. Includes numerical 0 to 100 scale.
FACES. This tool uses faces (cartoon to realistic) denoting pain from no pain to intense pain.
COMFORT Scale. Evaluates alertness, calmness or agitation, respiratory response, physical movement, heart rate, blood pressure, muscle tone, and facial tension.
Children’s Hospital of Eastern Ontario Pain Scale. CHEOPS is for children ages 1 to 7 and has been used on children ranging from 4 months to 17 years.
Children 5 to 7 Years Old
Body Outline. The child marks the location of pain on a simple drawing of a body; may use color.
Visual Analogue Scale. VAS is a simple horizontal line that indicates no pain to worst pain. Child marks line where he or she feels pain level is.
Poker Chip Tool. Four poker chips are given to child, and child picks 0 for no pain and 4 for most pain.
May use some of the previous scales, such as VAS or even FACES. Adolescents may like a numeric scale in which 0 is no pain and 10 is the worst pain imaginable. He or she is then asked to indicate a number between 0 and 10 for the current pain.
Taking Action Against Pain
Medicinal Management of Pain
Addiction: as defined by the American Society of Addiction Medicine is:
Treatments for Use as Pain Increases
Course Delivery Method and Format: