EVENDOL, a new behavioral pain scale for children ages 0 to 7 years in the emergency department: Design and validation

Fournier-Charrière, E.; Tourniaire, B.; Carbajal, Ricardo; Cimerman, Patricia; Lassauge, F.; Ricard, C.; Reiter, Florence; Turquin, P.; Lombart, Bénédicte; Letierce, Alexia; Falissard, Bruno

doi:10.1016/j.pain.2012.02.024

Cited by 88 publications

(56 citation statements)

References 34 publications

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“…If a self-report scale is being used to measure pain, it is essential the healthcare provider verifies that the child understands it. Published reviews and systematic reviews are available that can help us choose the appropriate pain scale; unfortunately there is no universal pain scale that can be used for all children (Table 1) [7,[15][16][17][18][19][20][21]. Regardless of the pain scale used, the meaning of specific scores should be determined as well as the limitations of each scales used [22].…”

Section: Pain Recognition and Assessment In Childrenmentioning

confidence: 99%

Managing Pediatric Pain in the Emergency Department

Bailey

Trottier

2016

Pediatr Drugs

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Far more attention is now given to pain management in children in the emergency department (ED). When a child arrives, pain must be recognized and evaluated using a pain scale that is appropriate to the child's development and regularly assessed to determine whether the pain intervention was effective. At triage, both analgesics and non-pharmacological strategies, such as distraction, immobilization, and dressing should be started. For mild pain, oral ibuprofen can be administered if the child has not received it at home, whereas ibuprofen and paracetamol are suitable for moderate pain. For patients who still require pain relief, oral opioids could be considered; however, many EDs have now replaced this with intranasal fentanyl, which allows faster onset of pain relief and can be administered on arrival pending either intravenous access or definitive care. Intravenous opioids are often required for severe pain, and paracetamol or ibuprofen can still be considered for their likely opioid-sparing effects. Specific treatment should be used for patients with migraine. In children requiring intravenous access or venipuncture, non-pharmacological and pharmacological strategies to decrease pain and anxiety associated with needle punctures are mandatory. These strategies can also be used for laceration repairs and other painful procedures. Despite the gaps in knowledge, pain should be treated with the most up-to-date evidence in children seen in EDs.

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Section: Pain Recognition and Assessment In Childrenmentioning

confidence: 99%

Managing Pediatric Pain in the Emergency Department

Bailey

Trottier

2016

Pediatr Drugs

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“…Only two scales have been designed specifically for or to include assessment of procedural pain in infants and/or children: the Modified Behavioural Pain Scale (MBPS) 20 and EVENDOL. 21 However, they are not supported by sufficient feasibility or psychometric data to unreservedly support their use. MBPS has had some testing to establish scale performance when used to assess immunisation pain in infants, and the results are promising.…”

Section: Introductionmentioning

confidence: 99%

Procedural Pain Scale Evaluation (PROPoSE) study: protocol for an evaluation of the psychometric properties of behavioural pain scales for the assessment of procedural pain in infants and children aged 6–42 months

et al. 2017

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IntroductionInfants and children are frequently exposed to painful medical procedures such as immunisation, blood sampling and intravenous access. Over 40 scales for pain assessment are available, many designed for neonatal or postoperative pain. What is not well understood is how well these scales perform when used to assess procedural pain in infants and children.AimThe aim of this study was to test the psychometric and practical properties of the Face, Legs, Activity, Cry and Consolability (FLACC) scale, the Modified Behavioural Pain Scale (MBPS) and the Visual Analogue Scale (VAS) observer pain scale to quantify procedural pain intensity in infants and children aged from 6–42 months to determine their suitability for clinical and research purposes.Methods and analysisA prospective observational non-interventional study conducted at a single centre. The psychometric and practical performance of the FLACC scale, MBPS and the VAS observer pain scale and VAS observer distress scale used to assess children experiencing procedural pain will be assessed. Infants and young children aged 6–42 months undergoing one of four painful and/or distressing procedures were recruited and the procedure digitally video recorded. Clinicians and psychologists will be recruited to independently apply the scales to these video recordings to establish intrarater and inter-rater reliability, convergent validity responsiveness and specificity. Pain score distributions will be presented descriptively; reliability will be assessed using the intraclass correlation coefficient and Bland-Altman plots. Spearman correlations will be used to assess convergence and linear mixed modelling to explore the responsiveness of the scales to pain and their capacity to distinguish between pain and distress.Ethics and disseminationEthical approval was provided by the Royal Children’s Hospital Human Research Ethics Committee, approval number 35220B. The findings of this study will be disseminated via peer-reviewed journals and presented at international conferences.

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“…De même, l'échelle d'hétéroévaluation Évendol en 15 points a été validée pour les enfants de zéro à sept ans [8], avec cependant la limite que constitue la nécessité d'une seconde évaluation de la douleur au moment de l'examen clinique. Dans ce cas, à partir de 4 sur 15 l'administration d'antalgiques est recommandée (Annexe B).…”

Section: Introductionunclassified

Prise en charge de la douleur aux urgences

Sudrial¹,

Combes²

2015

Réanimation

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La prise en charge de la douleur est devenue une priorité de santé publique depuis près de 20 ans. La douleur est un des motifs de consultation les plus fréquents aux urgences. Ces dernières années, de nombreux progrès ont été réalisés, concernant son évaluation par les échelles d'autoévaluation, la précocité de sa prise en charge dès l'accueil aux urgences et l'utilisation d'algorithmes décision-nels, qui permettent une optimisation de l'utilisation de nombreux antalgiques. La morphine reste le principal traitement des douleurs aiguës dans les structures d'urgences. Les anesthésies locales et locorégionales, ainsi que les sédations pour gestes douloureux, sont utilisées de plus en plus par les médecins urgentistes, mais nécessitent des protocoles de service validés et une bonne connaissance de leur utilisation. Ainsi, il reste des pistes d'amélioration, qui passent par des formations et par la sensibilisation de tous les acteurs à la prise en charge de la douleur au sein des structures d'urgences. Mots clés Kétamine · Propofol · Douleur · Urgences · MorphineAbstract Pain management has remained a public health priority since 20 years. Pain is one of the most frequent reasons for emergency room (ER) admissions. In recent years, much progress has been made regarding pain assessment, early pain management right from ER admission, as well as the use of decision-making algorithms. These have enabled a better use of the available painkillers including morphine, which remains the primary treatment for acute pain in the ER. Local and regional anesthesias, as well as sedation for painful procedures are increasingly used by emergency physicians but require approved protocols and a good understanding of their implementation. However, there are still areas for improvement such as the use of hypnosis.Improved pain management in emergency departments can be achieved through better training and raising awareness among professionals.

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EVENDOL, a new behavioral pain scale for children ages 0 to 7 years in the emergency department: Design and validation

Cited by 88 publications

References 34 publications

Managing Pediatric Pain in the Emergency Department

Managing Pediatric Pain in the Emergency Department

Procedural Pain Scale Evaluation (PROPoSE) study: protocol for an evaluation of the psychometric properties of behavioural pain scales for the assessment of procedural pain in infants and children aged 6–42 months

Prise en charge de la douleur aux urgences

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