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Pediatric emergency department analgesic practice
L R Friedland1, A M Pancioli, K M Duncan
1University of Cincinnati College of Medicine, Department of Pediatrics-Division of Emergency Medicine, Ohio, USA.
Pediatric Emergency Care
|April 1, 1997
Summary
Pediatric pain management for burns and fractures in the ED showed suboptimal analgesic use and home instructions in 1994. Improving initial doses, reducing wait times for pain relief, and documenting patient response are key areas for improvement.
Area of Science:
- Pediatric Emergency Medicine
- Pain Management
- Healthcare Quality Improvement
Background:
- Effective acute pain management is crucial in pediatric emergency departments (EDs).
- Previous studies highlight variability in pain management protocols.
- Identifying specific care gaps is essential for targeted interventions.
Purpose of the Study:
- To assess acute pain management practices for specific conditions in a pediatric ED.
- To identify areas for performance improvement in pediatric pain care.
- To evaluate analgesic administration, dosing, timeliness, and patient outcomes.
Main Methods:
- Retrospective chart review of patients in a pediatric ED.
- Inclusion of patients with sickle cell vasoocclusive crisis (VOC), long bone fractures, and burns.
- Data collected on analgesic use, dosage, timing, pain relief documentation, and home care instructions.
Main Results:
- 100% analgesic use for VOC, but lower rates for fractures (31%) and burns (26%).
- Recommended starting doses were administered to 78% (VOC), 69% (fracture), and 79% (burn) of patients.
- Mean time to analgesia varied: 52 min (VOC), 86 min (fracture), 29 min (burn).
- Pain relief documentation was highest for VOC (88%) compared to fractures (19%) and burns (29%).
- Home analgesic instructions were provided to 100% (VOC), 74% (fracture), and 27% (burn).
Conclusions:
- Significant opportunities exist to improve acute pain management for pediatric patients with burns and fractures in the ED.
- Optimizing initial analgesic doses and reducing administration time are critical.
- Enhanced documentation of pain relief and consistent home care instructions are necessary.