State-of-the-art pain management in the 21st century demands that pharmacological management must be combined with supportive and integrative (nonpharmacological) therapies to manage a child’s pain. At Children’s, we are using physical methods (e.g. cuddle/hug, massage, comfort positioning, heat, cold, TENS), cognitive behavioral techniques (e.g. guided imagery, hypnosis, abdominal breathing, distraction, biofeedback), as well as acupressure and aromatherapy.
For “needle pokes” (vaccinations, blood draws, etc.), for instance, we expect that kids are sitting upright (use sucrose in the age group birth to 12 months), so we numb their skin with topical anesthesia (e.g. EMLA-patch, LMX 4 percent lidocaine patch, or J-tip) and use distraction such as bubble blowing or blowing a pin wheel. Alternatives can be applications on your smartphone or tablet.
My personal favorite technique remains teaching children in self-hypnosis. However, in addition, I’m increasingly using apps on my iPhone or iPad with patients. Here are my top apps for pain and symptom management in kids:
10. Real ChalkBoard: Drawing on a realistic chalkboard with different-color chalk — much more fun than it sounds. ($1.99)
9. Talking Tom Cat: This is a cat that repeats everything you say in a funny voice. You then can record and share videos and send them by email, YouTube and Facebook. Kids really enjoy that they can make Tom the cat say funny stuff. (free)
8. Simply Being – Guided Meditation for Relaxation and Presence: Provides relaxation, stress relief and benefits of meditation without prior experience. It allows the child/teenager to choose from four meditation times and gives them the option to listen to the guided meditation with or without music or nature sounds. Kids also can listen to the music or nature sounds alone; more for older children and teenagers. (99 cents)
7. Drums! – A studio-quality drum kit in your pocket: As the name implies, this is a drum kit. Great for kids with too much (or too little) energy. Rock on! (99 cents)
6. Tesla Toy: “Tesla Toy” is a fun, interactive “particle toy.” When the fingers touch the screen, they generate what looks like a powerful electrical field that makes the thousands of particles react beautifully. Kids (and adults) often are mesmerized by this app for a long time. ($ 1.99)
5. Fruit Ninja: A “juicy” action game with squishy, splatty and satisfying fruit carnage! (99 cents)
4. Koi Pond: One is gazing into a pond of crystal-clear water with fish, turtles and more. Kids run their fingers across the cool surface of the pond and water ripples away from their touch. The koi fish, disturbed, dart away… only to quickly forget and swim close once more. (99 cents)
3. Easy-Bake Treats!: This is a highly recommended app; it let’s children make, bake, decorate, eat and share virtual cakes, cupcakes, cookies, cake pops and pizza. They pick their mix, fill the pan with batter and water, mix it all together and slide the pan into the virtual oven to cook. Then they can add candles to their cakes and cupcakes, too! Candles can be lit and re-lit for even more fun! Once they’ve baked and decorated their treats, kids can show off and share their delicious virtual creations with family and friends via email or Facebook. Highly addictive – kids can spend a long time on this app. (free)
2. The Healing Buddies Comfort Kit: “The Healing Buddies Comfort Kit” offers an interactive, virtual way for kids and teens at home, in a doctor’s office or in the hospital to learn and immediately benefit from self-care techniques to manage common symptoms like pain, worries, nausea, fatigue and trouble sleeping. The app contains several integrative medicine techniques adapted for use by children and teens that are quick and effective for symptom control so kids can get back to doing what they like to do – and need to do each day. The techniques included in this app are designed by leaders in the field of pediatric integrative medicine (physicians, nurses, psychologists and child life specialists) and have been tested for years in several leading children’s hospitals and clinics. (99 cents)
Disclaimer: The creation of the mobile app has been a collaborative effort of my department at Children’s Hospitals and Clinics of Minnesota with Ridgeview Medical Center and DesignWise Medical.
1. Balloonimals: Absolutely groovy; kids love it! This is my favorite app to distract a child in pain or discomfort. Beautifully rendered balloon animals spring to life when you blow into the microphone on your iPhone/iPad or swipe with your iPod Touch. Watch the balloon inflate and then give your phone a shake to start constructing your balloon animal. With each shake, your animal takes greater shape until… voila! Your balloon animal appears and is ready to play. Pet your “balloonimal” to see what tricks it can do. ($1.99)
Apps, which didn’t make the list but I still like a lot: “Art of Glow,” “Sand Garden,” “Build a Zoo,” “Naturespace,” “SkyView” and “Disney’s Small World”
Stefan Friedrichsdorf, MD, is medical director of the Kiran Stordalen and Horst Rechelbacher Pediatric Pain, Palliative and Integrative Medicine Clinic at Children’s – Minneapolis. This post originally appeared at NoNeedlessPain.org. Download the Children’s Hospitals and Clinics of Minnesota app.