Abstract
Aims: To explore the policies of Italian paediatric emergency departments (ED) towards management of acute pain in children.
Methods: Eleven paediatric and two general hospitals with separate paediatric triage were recruited. Policies regarding pain management at time of triage and in the emergency clinical area were surveyed through a structured questionnaire. Information regarding the hospital and the ED were also collected. Multiple correspondence analysis (MCA) was carried out to explore relationships between variables related to pain management and hospital characteristics. The study was supported by Angelini ACRAF.
Results: Six hospitals routinely carried out pain assessment at triage, and 7 in the emergency clinical area. Nine hospitals (69%) used validated tools such as FLACC (7 hospitals), Wong-Baker (7) visual analogic or visual numeric scales (8). EMLA cream for anticipated venous cannulation was used “sometimes” (10 to 50% of events) by 4 hospitals, and often (51 to 90%) by 1. MCA identified two main dimensions, explaining 85.3% of variance in pain management policies: 1) routine pain assessment, joint medical nursing protocols for pain treatment, and EMLA at least sometimes; and 2) pain measurement through validated tools and recording of results. Being a paediatric hospitals, university affiliation, medico-surgical and trauma emergency functions, global triage on a 24h basis, and possibility for short-stay observation were associated with higher scores on both dimensions.
Conclusions: Despite a general awareness of the relevance of acute pain in children and widespread presence of protocols, use of validated tools and prophylaxis of procedural moderate pain are still insufficiently applied.
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Losacco, V., Cuttini, M., Messi, G. et al. 134 Management of Acute Pain in Paediatric Emergency Departments: A Survey of Policies in Italy. Pediatr Res 68 (Suppl 1), 70 (2010). https://doi.org/10.1203/00006450-201011001-00134
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DOI: https://doi.org/10.1203/00006450-201011001-00134