Abstract
The Visual Analog Scale (VAS) is the gold-standard for pain assessment. Since it cannot always be used, staffs often assess pain with other scales in children with Painful Sickle Cell Crises-(PSCC) visiting the Emergency Department-(ED).
Objectives: To compare the initial severity of PSCC in children presenting to the ED according to the used pain scale.
Methods: Retrospective study of all one-year visits to a pediatric ED for a PSCC. ED policy allowed triage nurses to use the pain scale they deemed the most suitable for each child.
Results: From May 2008 to April 2009, 189 visits concerning 87 children were registered. In 149 (79%) visits, an initial pain score was recorded. Triage nurses assessed pain using four scales. The mean (SD) age was 12.3 (3.1) years for 97 (65.1%) visits of children assessed with a 0-10 VAS or Numerical Rating Scale (VAS-NRS group), 5.2 (3.4) years for 45 (30%) assessments with 0-10 Faces Scale, 4.2 (4.0) for 5 assessments with 0-15 EVENDOL, and 2.2 (2.2) for 2 assessments with 0-8 Objective Pain Scale (OPS); ANOVA p< 0.001. In order to uniform all the assessment data, EVENDOL and OPS were transformed into a 0-10 scale. The median (interquartile) uniformed pain scores were 7.0 (6.0- 8.0) for VAS-NRS, 4.0 (4.0-6.0) for Faces Scale, 4.0 (1.3-6.3) for EVENDOL, and 7.5 (5.0-10) for OPS; Kruskal-Wallis p< 0.001.
Conclusions Severity of pain in children with PSCC varied with the scale used. It is postulated that the Faces or the EVENDOL scale underestimate pain in PSCC.
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Courtois, E., Al Lawati, L., Tostivint, L. et al. 1365 Does the Pain Scale Type Influence the Assessed Pain Intensity in Painful Sickle Cell Crisis in the Pediatric Emergency Department?. Pediatr Res 68 (Suppl 1), 676 (2010). https://doi.org/10.1203/00006450-201011001-01365
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DOI: https://doi.org/10.1203/00006450-201011001-01365