Assessment of orofacial pain management in a pediatric emergency department and at home after discharge

Red, Yurena Aguilar de la; Martín, Gema Manrique; Márquez, Gloria Guerrero; Herrero, Concepción González; López, P. Vázquez; Navarro, Carlos

doi:10.5546/aap.2018.eng.28

Cited by 1 publication

(2 citation statements)

References 17 publications

(23 reference statements)

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“…A recent study in Quebec, Canada, showed that only 55% of children were screened for pain in the ED, thereby emphasizing the need to improve pediatric pain assessment [ 19 ]. Poor assessment results in a lack of treatment, and previous studies have shown that only 30%–40% of pediatric patients receive analgesia [ 2 , 3 , 21 ]. Our study had a higher rate of pain assessment (74.2%), but only 24.9% of those assessed received treatment.…”

Section: Discussionmentioning

confidence: 99%

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Predictors of triage pain assessment and subsequent pain management among pediatric patients presenting to the emergency department

Valani,

Kassam,

Jose

et al. 2023

PLoS ONE

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Background Pediatric patients with pain of various causes present to the emergency department. Appropriate assessment and management of pain are important aspects of emergency department treatment. However, only a few studies have identified the predictors of both outcomes. This study aimed to evaluate the rate of pain assessment at triage and subsequent management and to identify the predictors of each outcome. Methods This was a multi-center retrospective study based at five community emergency departments. Pediatric patients (< 18 years) with pain or injury who presented to the emergency department between February 2018 and May 2018 were included. In addition to patient demographics, the initial pain assessment at triage, reason for visit, and time to analgesia were determined. Further, the type and route of analgesia were identified in patients who received analgesia. Univariate and multivariable regression models were used to identify predictors of pain assessment and management. Results There were 4,128 patients with an average age of 9.6 years, and 49.1% of them were female. Only 74.2% of the patients underwent assessment for pain at triage, and 18.3% received analgesia. The median time to analgesia was 95 (IQR: 49–154) min. Most patients presented with head/neck (36.1%), upper limb (21.6%), and lower limb (19.9%) pain. The oral route was the most common analgesia delivery method (67.4%), and ibuprofen and acetaminophen were the primary agents used. Younger age, higher acuity, and presenting with head or neck pain were independent predictors of pain assessment at triage, while children 3–5 years and those with lower extremity pain were more likely to receive analgesia. Conclusion Although pain assessment at triage has improved in pediatric patients, there is still a major deficiency in adequate pain management. Our study highlights predictors of pain assessment and management that can be considered for improved pediatric care.

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Section: Discussionmentioning

confidence: 99%

“…In 2017, 19.7 million pediatric visits to EDs in the US were related to pain [1]. Despite ongoing advocacy for pain assessment and management of children in the ED, there is still a major limitation in achieving these goals [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%