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Paediatr Child Health. 2014 Apr;19(4):190-4.

Paediatric pain management practice and policies across Alberta emergency departments.

Author information

1
Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton; ; Women and Children's Health Research Institute, Edmonton;
2
Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton;
3
Department of Pediatrics, Faculty of Medicine, University of Calgary, Calgary, Alberta ; Alberta Children's Hospital Research Institute, Calgary, Alberta.

Abstract

in English, French

BACKGROUND:

Many children requiring acute care receive suboptimal analgesia.

OBJECTIVES:

To describe paediatric pain management practices and policies in emergency departments (EDs) in Alberta.

METHODS:

A descriptive survey was distributed to each of the EDs in Alberta.

RESULTS:

A response rate of 67% (72 of 108) was obtained. Seventy-one percent (42 of 59) of EDs reported the use of a pain tool, 29.3% (17 of 58) reported mandatory pain documentation and 16.7% (10 of 60) had nurse-initiated pain protocols. Topical anesthetics were reported to be used for intravenous line insertion by 70.4% of respondents (38 of 54) and for lumbar puncture (LP) by 30.8% (12 of 39). According to respondents, infiltrated anesthetic was used for LP by 69.2% (27 of 39) of respondents, and oral sucrose was used infrequently for urinary catheterization (one of 46 [2.2%]), intravenous line insertion (zero of 54 [0%]) and LP (one of 39 [2.6%]).

CONCLUSIONS:

Few Alberta EDs use policies and protocols to manage paediatric pain. Noninvasive methods to limit procedural pain are underutilized. Canadian paediatricians must advocate for improved analgesia to narrow this knowledge-to-practice gap.

KEYWORDS:

Analgesia; Emergency; Paediatrics; Pain; Survey

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