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| Home > Healthy People > January 2004 |
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Winter 2004
St. John’s, SMSU team to research new ways to
gauge infant pain
 In the past few years, the topic of face-recognition technology has been a
controversial one. Three years ago, the city of Tampa, Fla., used the
technology to scan the faces of people in crowds at the Super Bowl,
comparing them with images in a database of digital mug shots.
Busting criminals may not be the only useful application of this
technology, however.
 Southwest Missouri State University Computer Information Systems Assistant
Professor Sheryl Brahnam, Ph.D., is conducting a study with St. John’s to
determine if face-recognition technology could be utilized to identify
pain in babies.
“Another use of this technology, besides criminal prosecution, is to
classify human facial expression,” says Brahnam. “We theorize that this
technology can be used to classify expressions of pain, as well. According
to some of the literature that we’ve examined, most people are not that
good at recognizing infant pain. Infants can’t say, ‘I’m in pain,’ and
it’s hard to tell whether a baby’s cry means that they are hungry, tired,
having a bowel movement, or that they are in pain. There’s a lot of
potential for using this technology in the medical field.”
 Leann Rens, R.N., nursing director for St. John’s Children’s Hospital’s
Newborn Nursery and Neonatal Intensive Care Unit, says pain management is
extremely important in providing patient care and that for many years,
infants were not recognized as experiencing pain like older children and
adults.
“Now of course, that’s no longer the case,” Rens says. “This project with
Dr. Brahnam and SMS is a great way to advance what knowledge we have about
infant pain. Our staff is very interested in hearing any results that may
come out of this project.”
Rens says St. John’s Children’s Hospital utilizes a method called the
Neonatal Infant Pain Scale to rate babies’ pain levels.
“There are several parameters on the NIP Scale to determine pain, such as
vocalizations, movements and facial expressions. But this scale and others
like it is inaccurate to some degree because some babies will cry, make
facial expressions and move around when they’re in pain, while others will
completely shut down and go to sleep when they’re in pain. We utilize the
NIP Scale, but we also rely on our own judgment as caregivers to determine
if a baby is in pain and what methods we can employ to relieve that pain,”
Rens says.
She adds that St. John’s utilizes sucrose and comfort measures to relieve
minor pain in infants and Tylenol and other pain medications for more
intense pain.
“With newborns, we’ve had tremendous luck with sucrose to trigger the
release of endorphins to relieve pain during lab sticks. We just place a
drop of sucrose on the baby’s tongue and it starts to work immediately. We
use Tylenol and other measures during circumcisions and other, more
painful procedures,” she says.
Brahnam became interested in the different applications of face
recognition technology while writing her dissertation. After becoming
acquainted with St. John’s neonatologist Melinda Slack, M.D., Brahnam
proposed the idea for the project to Slack, who shares in interest in
identifying and rating pain levels in infants, especially those who are
premature or sick. In cooperation with St. John’s, Brahnam obtained
permission from the parents of 30 healthy infants in St. John’s Newborn
Nursery to photograph the babies’ facial expressions while they were at
rest, yawning, during a heel stick and while a light gust of air blew
across their faces.
“I took photos of about 30 babies at St. John’s over the course of about a
month last fall. The Newborn Nursery nurses at St. John’s were incredibly
cooperative, supportive and helpful while I was taking photos of the
babies, and Pete Miles with St. John’s Medical Research Group walked me
through each process to make this project happen,” Brahnam says.
Once the photos were taken, she edited them by dropping out the
backgrounds and then began running the photos through a series of
databases and algorithmic technologies in the SMSU Computer Information
Systems department in Glass Hall.
“I think we’ll have some results this spring,” Brahnam says. “This project
was a lot of fun. The babies were all so cute, and I had a great time
spending time with them.”
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