Pain management in children has significantly improved in the Italian emergency departments.
algometric scales
pain
protocols
training
triage
Journal
Acta paediatrica (Oslo, Norway : 1992)
ISSN: 1651-2227
Titre abrégé: Acta Paediatr
Pays: Norway
ID NLM: 9205968
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
16
09
2019
revised:
10
12
2019
accepted:
11
12
2019
pubmed:
21
12
2019
medline:
15
5
2021
entrez:
21
12
2019
Statut:
ppublish
Résumé
Pain in children is often poorly assessed and treated in Italian emergency departments (EDs) as found in a survey conducted among the centres of the "Pain in Pediatric Emergency Room (PIPER)" Study Group in 2010. Our aim was to evaluate the changes in pain management in Italian EDs in the last years. A structured questionnaire about pain assessment, protocols, use of local anaesthetics before venipuncture, opioids and adjuvants was mailed to 46 Italian EDs between November 2017 and April 2018. Pain was always assessed at triage in 34 centres (73.9%). Algometric scales were used in over 90% of EDs. Triage protocols were available in 37 centres (80.4%). Local anaesthetics before venipuncture were always used in six centres (13.0%). Protocols included opioids and adjuvants in 73.0% and 47.2%, respectively. Triage pain assessment was always done in 91.0% of the centres joining the PIPER Study Group up to 2015 and 56.5% in ones that joined the Group after 2015 (P = .017). Local anaesthetics before venipuncture were given in 39.1% of the centres joining until up to 2015 and 13.0% in ones that joined the Group after 2015 (P = .003). Paediatric pain management has significantly improved in Italian EDs in the last 8 years. The centres joining the PIPER Study Group for longer time have shown better results for the indicators considered in the survey.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1445-1449Informations de copyright
© 2019 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.
Références
Eerdekens M, Beuter C, Lefeber C, van den Anker J. The challenge of developing pain medications for children: therapeutic needs and future perspectives. J Pain Res. 2019;12:1649-1664.
Freund D, Bolick BN. Assessing a Child's pain. Am J Nurs. 2019;119:34-41.
Williams S, Keogh S, Douglas C. Improving paediatric pain management in the emergency department: an integrative literature review. Int J Nurs Stud. 2019;94:9-20.
Ruest S, Anderson A. Management of acute pediatric pain in the emergency department. Curr Opin Pediatr. 2016;28:298-304.
Benini F, Piga S, Zangardi T, et al. Nationwide study of headache pain in Italy shows that pain assessment is still inadequate in paediatric emergency care. Acta Paediatr. 2016;105:e200-e208.
Ferrante P, Cuttini M, Zangardi T, et al. Pain management policies and practices in pediatric emergency care: a nationwide survey of Italian hospitals. BMC Pediatr. 2013;13:139.
Wong C, Lau E, Palozzi L, Campbell F. Pain management in children: Part 1 - Pain assessment tools and a brief review of nonpharmacological and pharmacological treatment options. Can Pharm J. 2012;145:222-225.
Verghese ST, Hannallah RS. Acute pain management in children. J Pain Res. 2010;3:105-123.
Nuseir K, Kassab M, Almomani B. Healthcare providers' knowledge and current practice of pain assessment and management: how much progress have we made? Pain Res Manag. 2016;2016:8432973.
Pretorius A, Searle J, Marshall B. Barriers and enablers to emergency department nurses' management of patients' pain. Pain Manag Nurs. 2015;16:372-379.
Czarnecki ML, Guastello A, Turner HN, Wrona SK, Hainsworth KR. Barriers to pediatric pain management: a brief report of results from a multisite study. Pain Manag Nurs. 2019;20:305-308.
Pate JW, Hush JM, Hancock MJ, et al. A child's concept of pain: an international survey of pediatric pain experts. Children (Basel) 2018; 5(1):12.
Egunsola O, Wylie CE, Chitty KM, Buckley NA. Sstematic review of the efficacy and safety of gabapentin and pregabalin for pain in children and adolescents. Anesth Analg. 2019;128:811-819.
Fiore DC, Fettic LP, Wright SD, Ferrara BR. Antibiotic overprescribing: still a major concern. J Fam Pract. 2017;66:730-736.
Benini F, Congedi S, Rossin S, Pennella A. The PIPER Weekend study. children's and adults satisfaction regarding paediatric pain in Italian Emergency Department. Ann Ist Super Sanita. 2018;54:12-19.
Kusi Amponsah A, Björn A, Bam V, Axelin A. The effect of educational strategies targeted for nurses on pain assessment and management in children: an integrative review. Pain Manag Nurs. 2019;20:604-613.
Twycross A, Forgeron P, Williams A. Paediatric nurses' postoperative pain management practices in hospital based non-critical care settings: a narrative review. Int J Nurs Stud. 2015;52:836-863.
Decosterd I, Hugli O, Tamchès E, et al. Oligoanalgesia in the emergency department: short-term beneficial effects of an education program on acute pain. Ann Emerg Med. 2007;50:462-471.
Milani GP, Benini F, Dell'Era L, et al. Acute pain management: acetaminophen and ibuprofen are often under-dosed. Eur J Pediatr. 2017;176:979-982.
Di Mascio A, Bossini B, Barbi E, Benini F, Cozzi G. Use of ketamine by paediatricians in Italian paediatric emergency departments: a missed opportunity? Eur J Pediatr. 2019;178:587-591.
Stevens BJ, Yamada J, Promislow S, et al. Implementation of multidimensional knowledge translation strategies to improve procedural pain in hospitalized children. Implement Sci. 2014;9:120.