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Published on: October 11, 2011
Paediatric pain management practice and policies across Alberta emergency departments
Samina Ali1, Andrea L Chambers2, David W Johnson3
1Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton; ; Women and Children's Health Research Institute, Edmonton;
Background:
Many children requiring acute care receive suboptimal analgesia.
Objectives:
To describe paediatric pain management practices and policies in emergency departments (EDs) in Alberta.
Methods:
A descriptive survey was distributed to each of the EDs in Alberta.
Results:
A response rate of 67% (72 of 108) was obtained. Seventy-one percent (42 of 59) of EDs reported the use of a pain tool, 29.3% (17 of 58) reported mandatory pain documentation and 16.7% (10 of 60) had nurse-initiated pain protocols. Topical anesthetics were reported to be used for intravenous line insertion by 70.4% of respondents (38 of 54) and for lumbar puncture (LP) by 30.8% (12 of 39). According to respondents, infiltrated anesthetic was used for LP by 69.2% (27 of 39) of respondents, and oral sucrose was used infrequently for urinary catheterization (one of 46 [2.2%]), intravenous line insertion (zero of 54 [0%]) and LP (one of 39 [2.6%]).
Conclusions:
Few Alberta EDs use policies and protocols to manage paediatric pain. Noninvasive methods to limit procedural pain are underutilized. Canadian paediatricians must advocate for improved analgesia to narrow this knowledge-to-practice gap.
