How codeine metabolism affects its clinical use

Abstract

of recommendations 1. Recognition and alleviation of pain should be a priority when treating ill and injured children. This process should start at the triage, be monitored during their time in the ED and finish with ensuring adequate analgesia at, and if appropriate, beyond discharge. Level 5 evidence. 2. The RCEM Quality in Emergency Care Committee (QEC) standard of analgesia for moderate & severe pain within 20 minutes of arrival in the ED should be applied to children in all Emergency Departments. Patients in severe pain should have the effectiveness of analgesia re-evaluated within 60 minutes of receiving the first dose of analgesia. Level 5 evidence. 3. Patients in moderate pain should be offered oral analgesia at triage / assessment. Patients with moderate pain should have the effectiveness of analgesia re-evaluated within 60 minutes of the first dose of analgesia. Level 5 evidence.4. An audit against these standards should be done annually. Level 5 evidence.5. In treating pain, pay attention to the other factors distressing the child such as fear of the unfamiliar environment and people, parental distress, people in uniforms, needle avoidance, fear of injury severity etc. Level 5 evidence. 6.Training in pain relief in children for all staff involved in patient care is essential to ensure quality and timely management. Level 5 evidence.Management of pain in children (REV July 2017)3 ScopeThis guideline has been developed and reviewed in order to provide clear guidance on the standards for timeliness of provision of analgesia, and to provide an approach to the delivery of analgesia based on available evidence and consensus of the RCEM QEC. It is applicable to all children presenting to Emergency Departments in the UK.