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Pain in young children attending an accident and emergency department
C McCarthy1, S Hewitt, I Choonara
1Academic Division of Child Health, University of Nottingham, Derbyshire Children's Hospital Derby.
Insights
Assessing pain in young children in accident and emergency (A&E) departments using the toddler-preschooler postoperative pain scale (TPPPS) showed that while many children experience pain, analgesia use could be improved. The TPPPS appears suitable for A&E settings.
Area of Science:
- Pediatric Emergency Medicine
- Pain Management
- Clinical Assessment Tools
Background:
- Accurate pain assessment in young children in emergency settings is challenging.
- Existing pain scales may require adaptation for the accident and emergency (A&E) environment.
- Effective pain management is crucial for pediatric patient care.
Purpose of the Study:
- To evaluate the efficacy of the toddler-preschooler postoperative pain scale (TPPPS) for assessing pain in young children in an A&E department.
- To assess the utilization of analgesia in this pediatric population.
- To identify potential improvements in pain management strategies.
Main Methods:
- A cohort of 100 children aged 1-5 years presenting to an A&E department were enrolled.
- Pain was assessed using a modified TPPPS, a parent-reported visual analogue scale, and a nurse-reported numerical scale.
- Data on analgesia administration were collected and analyzed.
Main Results:
- A majority of children were identified as experiencing pain across all assessment methods (TPPPS: 60%, nurses: 58%, parents: 63%).
- Only 30% of children received analgesia, indicating a potential gap in pain management.
- Children with higher pain scores, as determined by nurses or the TPPPS, consistently received analgesia.
Conclusions:
- The modified TPPPS demonstrates suitability for pain assessment in young children within A&E departments.
- There is a clear need to improve the management and administration of analgesia for pediatric patients in emergency settings.
- Further research and implementation of standardized pain management protocols are recommended.
Objectives:
To assess pain in young children presenting to an accident and emergency (A&E) department. To evaluate the use of the toddler-preschooler postoperative pain scale (TPPPS) and the use of analgesia in these children.
Methods:
100 children aged 1-5 years presenting to an A&E department were assessed for pain. Pain assessments were carried out using a modified form of the TPPPS; a visual analogue scale by parents and a numerical scale by nursing staff.
Results:
The majority of children were assessed as having pain: 60 by the TPPPS, 58 by the nurses and 63 by parents. Only 30 children, however, received analgesia. Children with the highest pain scores as assessed by nursing staff or using the TPPPS all received analgesia.
Conclusions:
The pain scale appears suitable for use in young children in A&E departments. The subsequent management of pain in young children could be improved.