Children may receive substandard pain management care in non-pediatric EDs, study finds

Researchers at the University of Sherbrooke in Quebec, Canada, found children often receive substandard pain management care when treated in a nonpediatric emergency department, according to research presented Sept. 13 at the International Association for the Study of Pain's World Congress on Pain in Boston and cited by MDLinx.

Here are three things to know:

1. For the study, researchers observed nurses caring for 47 stable, but bedridden children in a nonpediatric ED at an academic hospital in Quebec. Researchers recorded 112 observation hours between December 2017 and January 2018. The researchers told the nurses they were participating in a survey assessing interactions between nurses and children. The researchers were really assessing the quality of nursing care for pain management.

2. Twenty-eight percent of children visited the ER for pain, and 91 painful moments were identified. However, nurses only used pain assessment scales in 10 percent of cases, even though they all received formal training in pediatric pain management.

3. In 75 percent of cases, children received acetaminophen and ibuprofen. Thirty percent of patients in these cases also had a fever. Four percent of patients received sucrose before painful procedures. After nurses attempted to reduce pain with drugs or nonpharmacological methods, they re-evaluated children's pain levels in 19 percent of cases.

"Our results show that pain remains suboptimally managed in our ER despite training given (how to perform pain evaluations and pain care knowledge/attitude), guides of practice, and on-site available pain management protocols," the authors wrote in an abstract cited by MDLinx. "These observations attest that the treatment of procedural pain or pain as part of the presenting disease could be improved. Nursing educational programs for pain treatments in specific populations, such as pediatric patients, needs to be reconsidered."

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