Question the patient

Use a pain rating scale

Evaluate behavior and physiological signs

Secure the family's involvement

Take cause of pain into account

Take action and assess effectiveness

When obtaining the patient's history, the interview of both the child and the par-ents/caregivers is essential as children 5 years of age and older may be able to describe and portray their pain experience more accurately than their parents as parental perceptions, biases, and personal needs may be reflected in the parents' depiction of the pain history. The clinician should also be aware of the cultural beliefs surrounding the child's pain experience, the potential for secondary gains, and the overall family dynamic between the child and parent/caregiver when obtaining a complete history. The OLDCARTS mnemonic is often a useful guide when conducting a pain-specific history:

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