<p>Pain in injured children is often underestimated or inadequately treated in emergency services. The main reasons are uncertainties in pain assessment, dosage, and fear of side effects. This article presents practical approaches for safe, child-friendly pain diagnosis and therapy in prehospital emergency care. Practical instruments such as the KUSS (“Kindliche Unbehagens- und Schmerzskala”) scale and facial scales for pain assessment, methods for weight estimation, and pharmacological and nonpharmacological measures are presented. Structured parental involvement, the use of standardized observation instruments, and visual aids significantly improve pain assessment in children. Nonpharmacological measures such as positioning, sedation, and physical contact have a&#xa0;supportive effect. Intranasal analgesia has proven to be rapid, safe, and effective. Standardized dosing aids are essential for safe, weight-adapted medication administration. Early pain therapy reduces physical and emotional stress and facilitates subsequent care. Intranasal administration has established itself as the preferred route of access and is the first-line treatment. The use of familiar medications and familiar tools (e.g., dosage charts) promotes confidence in emergency response. Pain relief is not an optional goal, but is an essential and integral component of acute emergency care for children.</p>