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Wednesday, May 18, 2011

Pain evaluation for Spanish speakers

Very young surgical patients cannot tell their caregivers how much pain they are enduring. For this reason, hospital staff must carefully evaluate the behavior of their young charges in order to determine whether the children require more or less pain medication. The current pain evaluation tools are expressed in English, which can make it hard for Spanish-speaking medical professionals to distinguish nuanced changes. In order to remedy this situation, doctors at Hospital Universitario La Paz have created a new scale especially for Spanish-speakers.

The most common pain evaluation scale for young children is called the CHEOPS scale, which stands for Children’s Hospital Eastern Ontario Pain Scale. It is recommended for children aged 1 to 7 years old, and assesses things like rigidity, in addition to more obvious cues like crying. The new pediatric acute pain scale is dubbed LLANTO, which is a Spanish acronym of crying, attitude, breathing, muscle tone and facial expression. Besides being in Spanish, the new scale does not rely on any electronic monitoring devices.

The LLANTO scale was compared to the CHEOPS scale in 54 children, aged one month to six years. Each child was evaluated on both pain scales before and after receiving a post-operative analgesic treatment. There was a high correlation between the two scales, meaning that an attending health care professional could confidently use either scale to assess her patients. Having a quick way to determine the pain levels in young children without having to translate anything would be a big help in many parts of the world.