Evaluation of Pain in the Pediatric Emergency Department and the Request of Analgesia.
Journal
Pediatric emergency care
ISSN: 1535-1815
Titre abrégé: Pediatr Emerg Care
Pays: United States
ID NLM: 8507560
Informations de publication
Date de publication:
01 07 2021
01 07 2021
Historique:
pubmed:
9
6
2021
medline:
19
8
2021
entrez:
8
6
2021
Statut:
ppublish
Résumé
To determine the acute pain level associated with request for analgesia by children and their parents in the pediatric emergency department (ED) when pain was assessed by verbal numeric scale (VNS), visual analog scale (VAS), and verbal rating scale (VRS). A secondary analysis of a prospective cohort study using a sample of children aged 8 to 17 presenting to the ED with acute pain. Patients and their parents were asked to quantify the child's pain on the VNS, VAS, and VRS. Scores for patients and parents who answered "yes" to the request of analgesia were compared with those responding "no." A total of 202 patients aged 12.2 ± 2.6 years were enrolled. The median levels of pain associated with a request of analgesia and no request for analgesia by the patient were: 6.0 (4.0-7.4) and 5.0 (3.0-6.0) (Δ 1.0; 95% confidence interval [CI], 0.5-2.0) for the VNS; 5.7 (3.9-7.2) and 4.3 (2.6-5.8) (Δ 1.3; 95% CI, 0.6-1.9) for the VAS; and 2.0 (2.0-2.0) and 2.0 (1.0-2.0) (Δ 0.0; 95% CI, 0.0-0.0) for the VRS. Children who requested analgesia had higher pain scores on the VNS and the VAS, than those who did not request analgesia. No difference was demonstrated with the VRS. The pain scores between the analgesia request categories could overlap. This suggests that children seen in the ED should be asked if they want analgesia to decrease their acute pain.
Identifiants
pubmed: 34101686
doi: 10.1097/PEC.0000000000002475
pii: 00006565-202107000-00014
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e356-e359Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
Disclosure: Conflict of interest and source of funding: None.
Références
Friedland LR, Kulick RM. Emergency department analgesic use in pediatric trauma victims with fractures. Ann Emerg Med . 1994;23:203–207.
Curtis LA. Pain management in the emergency department. Emerg Med Pract . 2006;8.
MacLean S, Obispo J, Young KD. The gap between pediatric emergency department procedural pain management treatments available and actual practice. Pediatr Emerg Care . 2007;23:87–93.
Fein JA, Zempsky WT, Cravero JP; Committee on Pediatric Emergency Medicine and Section on Anesthesiology and Pain Medicine; American Academy of Pediatrics. Relief of pain and anxiety in pediatric patients in emergency medical systems. Pediatrics . 2012;130:e1391–e1405.
Singer AJ, Garra G, Chohan JK, et al. Triage pain scores and the desire for and use of analgesics. Ann Emerg Med . 2008;52:689–695.
Crocker PJ, Higginbotham E, King BT, et al. Comprehensive pain management protocol reduces children's memory of pain at discharge from the pediatric ED. Am J Emerg Med . 2012;30:861–871.
Krauss BS, Calligaris L, Green SM, et al. Current concepts in management of pain in children in the emergency department. Lancet . 2016;387:83–92.
Allione A, Melchio R, Martini G, et al. Factors influencing desired and received analgesia in emergency department. Intern Emerg Med . 2011;6:69–78.
Lecomte F, Huet S, Audureau E, et al. Patients in pain that refuse acetaminophen at triage. Am J Emerg Med . 2014;32:388–389.
Voepel-Lewis T, Burke CN, Jeffreys N, et al. Do 0-10 numeric rating scores translate into clinically meaningful pain measures for children? Anesth Analg . 2011;112:415–421.
Voepel-Lewis T. Pain assessment and decision making: have we missed the mark? Pediatr Pain Let . 2011;13:1–6.
Silka PA, Roth MM, Moreno G, et al. Pain scores improve analgesic administration patterns for trauma patients in the emergency department. Acad Emerg Med . 2004;11:264–270.
Probst BD, Lyons E, Leonard D, et al. Factors affecting emergency department assessment and management of pain in children. Pediatr Emerg Care . 2005;21:298–305.
Boyd RJ, Stuart P. The efficacy of structured assessment and analgesia provision in the paediatric emergency department. Emerg Med J . 2005;22:30–32.
Vazirani J, Knott JC. Mandatory pain scoring at triage reduces time to analgesia. Ann Emerg Med . 2012;59:134–8.e2.
Bailey B, Daoust R, Doyon-Trottier E, et al. Validation and properties of the verbal numeric scale in children with acute pain. Pain . 2010;149:216–221.
Viera AJ, Garrett JM. Understanding interobserver agreement: the kappa statistic. Fam Med . 2005;37:360–363.
von Baeyer CL. Children's self-report of pain intensity: what we know, where we are headed. Pain Res Manag . 2009;14:39–45.
Powell CV, Kelly AM, Williams A. Determining the minimum clinically significant difference in visual analog pain score for children. Ann Emerg Med . 2001;37:28–31.
Gauthier JC, Finley GA, McGrath PJ. Children's self-report of postoperative pain intensity and treatment threshold: determining the adequacy of medication. Clin J Pain . 1998;14:116–120.
Shavit I, Kofman M, Leder M, et al. Observational pain assessment versus self-report in paediatric triage. Emerg Med J . 2008;25:552–555.
Puntillo K, Neighbor M, O'Neil N, et al. Accuracy of emergency nurses in assessment of patients' pain. Pain Manag Nurs . 2003;4:171–175.
Maciocia PM, Strachan EM, Akram AR, et al. Pain assessment in the paediatric Emergency Department: whose view counts? Eur J Emerg Med . 2003;10:264–267.
Kozlowski MJ, Wiater JG, Pasqual RG, et al. Painful discrimination: the differential use of analgesia in isolated lower limb injuries. Am J Emerg Med . 2002;20:502–505.