Evelyne D Trottier1, Samina Ali2, Sylvie Le May3, Jocelyn Gravel4. 1. Division of Pediatric Emergency Medicine, Centre hospitalier universitaire Sainte-Justine, University of Montreal, Montreal, Quebec; 2. Department of Pediatrics, University of Alberta, Edmonton, Alberta; ; Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta; 3. Centre hospitalier universitaire Sainte-Justine Research Centre; ; Faculty of Nursing, University of Montreal, Montreal, Quebec. 4. Division of Pediatric Emergency Medicine, Centre hospitalier universitaire Sainte-Justine, University of Montreal, Montreal, Quebec; ; Centre hospitalier universitaire Sainte-Justine Research Centre;
Abstract
BACKGROUND: Management of children's pain and anxiety in the emergency department is likely suboptimal. OBJECTIVE: To determine the availability of currently used strategies in Canadian paediatric emergency departments. METHODS: A cross-sectional survey involving all centres of the Pediatric Emergency Research Canada group was performed. The primary outcome was the availability of specific procedures for pain and anxiety management for children in the emergency department. One person per centre was identified to complete the survey. Data were collected from October 2013 to January 2014 using an electronic survey tool. RESULTS: All 15 Pediatric Emergency Research Canada centres agreed to participate. The verbal numerical scale was widely used (80%) to assess pain. One-half of respondents (53%) had access to a child life specialist. The following techniques were available for minor procedures: television as a distraction tool (87% of respondents), topical anesthetic before intravenous needle insertion (73%) and positioning of the child on parent's lap (60%); most remaining centres reported that these could be easily implemented. Intravenous morphine was available at every centre. Intranasal fentanyl was available (60%) or considered to be easy to implement (33%). Few centres reported availability of clinical guidelines regarding pain for doctors (27%) and nurses (40%); all respondents considered them to be easy to implement. CONCLUSIONS: There was wide variation in paediatric pain and anxiety management strategies among tertiary care Canadian emergency departments. Several pain-reduction procedures (distraction, positioning on parent's lap, topical anesthetic, intranasal administration) were identified that could be easily implemented to address the gap.
BACKGROUND: Management of children's pain and anxiety in the emergency department is likely suboptimal. OBJECTIVE: To determine the availability of currently used strategies in Canadian paediatric emergency departments. METHODS: A cross-sectional survey involving all centres of the Pediatric Emergency Research Canada group was performed. The primary outcome was the availability of specific procedures for pain and anxiety management for children in the emergency department. One person per centre was identified to complete the survey. Data were collected from October 2013 to January 2014 using an electronic survey tool. RESULTS: All 15 Pediatric Emergency Research Canada centres agreed to participate. The verbal numerical scale was widely used (80%) to assess pain. One-half of respondents (53%) had access to a child life specialist. The following techniques were available for minor procedures: television as a distraction tool (87% of respondents), topical anesthetic before intravenous needle insertion (73%) and positioning of the child on parent's lap (60%); most remaining centres reported that these could be easily implemented. Intravenous morphine was available at every centre. Intranasal fentanyl was available (60%) or considered to be easy to implement (33%). Few centres reported availability of clinical guidelines regarding pain for doctors (27%) and nurses (40%); all respondents considered them to be easy to implement. CONCLUSIONS: There was wide variation in paediatric pain and anxiety management strategies among tertiary care Canadian emergency departments. Several pain-reduction procedures (distraction, positioning on parent's lap, topical anesthetic, intranasal administration) were identified that could be easily implemented to address the gap.
Authors: Sarah Leahy; Robert M Kennedy; Joy Hesselgrave; Karen Gurwitch; Mary Barkey; Toni F Millar Journal: Pediatrics Date: 2008-11 Impact factor: 7.124
Authors: Samina Ali; Manasi Rajagopal; Terry Klassen; Lawrence Richer; Christopher McCabe; Andy Willan; Maryna Yaskina; Anna Heath; Amy L Drendel; Martin Offringa; Serge Gouin; Antonia Stang; Scott Sawyer; Maala Bhatt; Serena Hickes; Naveen Poonai Journal: BMJ Open Date: 2020-06-21 Impact factor: 2.692
Authors: Leah I Stein Duker; Anita R Schmidt; Phung K Pham; Sofronia M Ringold; Alan L Nager Journal: Front Pediatr Date: 2021-01-05 Impact factor: 3.418
Authors: Emmanuelle Fauteux-Lamarre; Franz E Babl; Andrew J Davidson; Donna Legge; Katherine J Lee; Greta M Palmer; Sandy M Hopper Journal: BMJ Paediatr Open Date: 2018-01-24