+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Routine pain scoring does not improve analgesia provision for children in the emergency department

Routine pain scoring does not improve analgesia provision for children in the emergency department

Emergency Medicine Journal 26(10): 695-697

Scoring pain should lead to providing better analgesia for children attending the emergency department (ED). Our ED found that it offered analgesia to only 75% of children with painful injuries-36% of them receiving opiates, while scoring pain in 74%. This report describes what happened when we tried to ensure every child had their pain scored in an effort to improve analgesia provision. We ensured mandatory pain scoring at triage during the introduction of our computerised notes system, backing this up with extra training of new staff and increased publicity of pain scoring tools. A retrospective audit was conducted after the intervention looking for completion of a pain score, provision of and type of analgesia. The study included children with long bone fractures or partial or full-thickness burns attending the ED. Following the intervention, we found that of 163 children, 97% had their pain scored on a zero-to-10 scale but only 66% received analgesia and only 10% were given opiates. The intervention was effective at achieving nearly universal early assessment and documentation of pain. This did not translate to an improvement in analgesic provision. Other means of changing behaviour need to be studied, possibly using the computerised record again to obligate analgesia provision.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 055623173

Download citation: RISBibTeXText

PMID: 19773482

DOI: 10.1136/emj.2008.065193

Related references

PAin SoluTions In the Emergency Setting (PASTIES)--patient controlled analgesia versus routine care in emergency department patients with non-traumatic abdominal pain: randomised trial. Bmj 350: H3147, 2015

PAin SoluTions In the Emergency Setting (PASTIES)--patient controlled analgesia versus routine care in emergency department patients with pain from traumatic injuries: randomised trial. Bmj 350: H2988, 2015

PAin SoluTions In the Emergency Setting (PASTIES); a protocol for two open-label randomised trials of patient-controlled analgesia (PCA) versus routine care in the emergency department. Bmj Open 3(2):, 2013

Pain Solution In The Emergency Setting (Pasties); An Open-Label Randomised Trial Of Patient-Controlled Analgesia (Pca) Versus Routine Care In Patients Attending The Emergency Department With Traumatic Injuries. Emergency Medicine Journal 31(9): 785-786, 2014

The Cost-Effectiveness Of Patient Controlled Analgesia Versus Routine Care In Patients Presenting To The Emergency Department In Pain, Who Are Subsequently Admitted To Hospital. Emergency Medicine Journal 33(12): 907.2-908, 2016

Predictors for opioid analgesia administration in children with abdominal pain presenting to the emergency department. Clinical Journal of Pain 24(1): 11-15, 2008

Administering analgesia sublingually is a suitable option for children with acute abdominal pain in the emergency department. Acta Paediatrica 108(1): 143-148, 2019

The efficacy of structured assessment and analgesia provision in the paediatric emergency department. Emergency Medicine Journal 22(1): 30-32, 2005

Emergency department crowding is associated with decreased quality of analgesia delivery for children with pain related to acute, isolated, long-bone fractures. Academic Emergency Medicine 18(12): 1330-1338, 2011

Emergency department allies: a controlled trial of two emergency department-based follow-up interventions to improve asthma outcomes in children. Pediatrics 117(4 Pt 2): S127-S134, 2006

A protocol to improve analgesia use in the accident and emergency department. Journal of Accident and Emergency Medicine 13(3): 177-179, 1996

Acute coronary syndrome risk prediction of rapid emergency medicine scoring system in acute chest pain. An observational study of patients presenting with chest pain in the emergency department in Central Saudi Arabia. Saudi Medical Journal 38(9): 900-904, 2017

An interventional study to improve the quality of analgesia in the emergency department. Cjem 10(5): 435-439, 2008

Clinical scoring system may improve yield of head CT of non-trauma emergency department patients. Emergency Radiology 22(5): 511-516, 2015

The impact of emergency department patient-controlled analgesia (PCA) on the incidence of chronic pain following trauma and non-traumatic abdominal pain. Anaesthesia 74(1): 69-73, 2019