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Eur J Pain. 2019 Dec 30. doi: 10.1002/ejp.1527. [Epub ahead of print]

Evolution in acute pain assessment and treatment in the pediatric emergency department of a tertiary health care center.

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Faculty of Medicine, Medical Academy, Lithuanian university of health sciences, A. Mickevičiaus g. 9, Kaunas, LT-44307.
Department of Pediatrics, Lithuanian University of Health Sciences Kauno klinikos, Eivenių g. 2, Kaunas, LT-50161.



Pediatric pain remains one of the most misunderstood, under-diagnosed and under-treated medical problems in children.


To investigate the accuracy of acute pain assessment and management in the Pediatric Emergency Department in Lithuanian University of Health Sciences Hospital.


We performed a retrospective record analysis before (the year 2017) and after (the year 2018) pediatric pain training course was conducted. In total, 1000 randomly selected outpatient records were analyzed. We divided all patients into two groups: group A records from 2017, group B - from 2018. Patients were further divided into trauma and non-trauma and subdivided into 4 different age groups. We collected patient age, the origin of pain, pain characteristics, pain score, and medication.


We compared 500 children in each group. Group A and B consisted of 154 (30.8%) and 116 (23.2%) trauma patients respectively. The pain was scored less in group A (420 children (84%)) compared to group B (94.4% of all 500 patients, p<0.001). In all age groups, the pain was assessed more often, and pain medication was prescribed more often in group B compared to group A (p <0.001). There was a tendency to assess pain more often in group A non-trauma patients (p=0.054). However, pain relief in trauma patients was less adequate compared to non-trauma.


Our research showed improvement in pain evaluation and treatment after systemic and local changes in PED. In group B, pain was evaluated more frequently, and patients received pain medication more often than in group A. Teenagers are still less likely to receive analgesics than toddlers. Tendency remains to give fewer painkillers to trauma patients compared to non-trauma children.


emergency; pain; pain assessment; pain treatment; pediatric


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