The complexity of pre-hospital pain management in children

This comment aims to illustrate and discuss the complexity of the pain management process for children in the pre-hospital setting. We have developed a process map illustrating the four facets of pre-hospital pain management in children; the illness / injury causing the pain, the child’s perception of the pain, the ambulance clinician’s assessment of the pain and the ambulance clinician’s management of the pain. These four facets are influenced by a number of factors and informed by an overarching theory of pain: gate control theory. Pre-hospital pain management in children is extremely complex. Further research is required to explore the associations and influencing factors within this process map.