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A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
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Published on: November 9, 2016

Paediatric analgesia in an Emergency Department

C Hawkes1, G Kelleher, J Hourihane

  • 1Cork University Hospital, Wilton, Cork. cphawkes@gmail.com

Irish Medical Journal
|June 19, 2008
PubMed

Insights

Improving pediatric pain management in the Emergency Department (ED) is crucial. A nurse-initiated analgesia protocol showed a slight improvement in providing pain relief to children with major fractures, though pain score documentation remains a challenge.

Area of Science:

  • Pediatric Emergency Medicine
  • Pain Management
  • Healthcare Quality Improvement

Background:

  • Effective pain management in pediatric patients within the Emergency Department (ED) is a critical performance metric.
  • Audits are essential for evaluating and enhancing the quality of care provided to children experiencing pain.

Purpose of the Study:

  • To audit the provision of analgesia for pediatric patients in an Irish ED.
  • To assess the impact of introducing a nurse-initiated analgesia protocol on pain management timeliness and rates.
  • To identify areas for improvement in pain assessment and documentation.

Main Methods:

  • An initial audit of 95 children (aged 1-16) in an Irish ED recorded time to analgesia and provision rates.
  • Following circulation of results, a nurse-initiated analgesia protocol was implemented.
  • A follow-up audit of 145 patients evaluated the protocol's effectiveness.

Main Results:

  • Analgesia provision for major fractures improved slightly from 55.6% to 61.1% after protocol implementation, with a significant reduction in time to analgesia (median 54 minutes to 7 minutes).
  • Pain score documentation remained poor, improving marginally from 0% to 19.3%.

Conclusions:

  • A nurse-initiated analgesia protocol can positively impact the timeliness and rate of pain management for pediatric patients with major fractures in the ED.
  • Significant challenges persist in the consistent documentation of pain scores.
  • Other Irish EDs are encouraged to conduct similar audits to improve pediatric pain management.

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