The Royal College of Emergency Medicine composite pain scale for children: level of inter-rater agreement

James, Ffion; Edwards, Rosie; James, Nirmal; Dyer, Rhian; Goodwin, Victoria A

doi:10.1136/emermed-2015-205517

Cited by 5 publications

(11 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of 65 scales, 32 (49%) were validated to assess acute pain, 4,11,12,14,[16][17][18][19][20][21][24][25][26][27]29,[32][33][34][35]37,38,[41][42][43]45,[52][53][54][55][56]60,61,64,67,[70][71][72][73][74]76,79,84,89 14 (22%) to assess prolonged pain, 4,13,15,22,24,[28][29][30]35,[37]…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Pain and Sedation Scales for Neonatal and Pediatric Patients in a Preverbal Stage of Development

et al. 2019

View full text Add to dashboard Cite

IMPORTANCEBecause children in a preverbal stage of development are unable to voice their feelings, they completely depend on their caregiving team for the interpretation and management of their pain and discomfort. Thus, accurately validated scales to assess pain and sedation levels are crucial.OBJECTIVE To provide clinicians a complete overview on the validity and reliability of the existing pain and sedation scales for different target populations (preterm infants, term infants, and toddlers) and in different clinical contexts.EVIDENCE REVIEW BIOSIS Previews, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Embase, MEDLINE, PsycCRITIQUES, PsycINFO, PSYNDEXplus Literature and Audiovisual Media, and PSYNDEXplus Tests were the databases screened from their inception to August 2018. All studies examining the validity or reliability of a given pain or sedation scale for patients in a preverbal stage of development were included in this systematic review. Those scales that were tested for at least construct validity, internal consistency, and interrater reliability were subsequently scored using the consensus-based standards for the selection of health measurement instruments (COSMIN) checklist.FINDINGS In total, 89 validation articles comprising 65 scales were included. Fifty-seven scales (88%) were useful for assessing pain, 13 scales (20%) for assessing sedation, and 4 scales (6%) for assessing both conditions. Forty-two (65%) were behavioral scales, and 23 (35%) were multidimensional scales. Eleven scales (17%) were validated for infants on mechanical ventilation. Thirty-seven scales (57%) were validated for preterm infants, 24 scales (37%) for term and preterm infants, 7 scales (11%) for term-born children, 7 scales (11%) for preterm infants, term infants, and toddlers, and 17 scales (26%) for term infants and toddlers. Twenty-eight scales (43%) considered construct validity, internal consistency, and interrater reliability.CONCLUSIONS AND RELEVANCE Clinicians should consider using scales that are validated for at least construct validity, internal consistency, and interrater reliability, combining this information with the population of interest and the construct the scale is intended to measure.

show abstract

Section: Resultsmentioning

confidence: 99%

“…Of 65 scales, 42 (65%) were behavioral scales 11,13,15,[18][19][20]22,26,[28][29][30]32,34,35,46,47,[52][53][54][55][56][58][59][60][61][62][63][64]66,67,[70][71][72][73][74][75][76][77][78][79][80][82][83][84][85][86][87][88]91 and 23 (35%) were multidimensional scales 4,12,14,16,17,<...…”

Section: Resultsmentioning

confidence: 99%

Pain and Sedation Scales for Neonatal and Pediatric Patients in a Preverbal Stage of Development

et al. 2019

View full text Add to dashboard Cite

show abstract

“…The 40 studies are grouped and displayed under the 4 dyads: child vs caregiver (n = 30), 2 , 4 – 11 , 13 , 15 , 18 , 19 , 23 , 27 , 31 , 34 , 36 , 39 , 41 , 43 , 44 , 48 , 53 , 54 , 56 , 57 , 61 , 64 , 67 child vs HCP (n = 17), 8 , 11 , 13 , 14 , 16 , 23 , 31 , 35 , 41 , 44 , 46 , 51 , 53 , 54 , 57 , 60 , 64 caregiver vs HCP (n = 10), 8 , 11 , 13 , 23 , 41 , 44 , 53 , 54 , 64 , 67 and nurse vs other HCPs (n = 5). 17 , 21 , 26 , 35 , 59 Fifteen studies examined more than one dyad (Appendix B, available at http://links.lww.com/PR9/A168 ).…”

Section: Resultsmentioning

confidence: 99%

“…The results were not statistically pooled. Two studies using ICC or weighted kappa were highly discordant (ES 5 0.17 26 and 0.87 59 ). One study that used a Pearson correlation showed a high ES (ES 5 0.90 35 ).…”

Section: Consistency Of Pediatric Pain Ratings Between the Nurse And ...mentioning

confidence: 97%

Consistency of pediatric pain ratings between dyads: an updated meta-analysis and metaregression

Zhou

Albrecht

Roberts

et al. 2022

PR9

View full text Add to dashboard Cite

show abstract

“…RCEM recommends the use of the attached assessment tool or a locally developed alternative. The Ladder element (which included a 0-10 numerical rating scale) of the scale has been removed following evidence suggesting limited advantage to this section (8) .…”

Section: Pain Assessmentmentioning

confidence: 99%

How codeine metabolism affects its clinical use

2021

Pharmaceutical Journal

View full text Add to dashboard Cite

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.

show abstract

The Royal College of Emergency Medicine composite pain scale for children: level of inter-rater agreement

Abstract: The Ladder score could be omitted from this composite tool as it has poor inter-rater agreement in comparison with the other indicators.

Cited by 5 publications

References 13 publications

Pain and Sedation Scales for Neonatal and Pediatric Patients in a Preverbal Stage of Development

Pain and Sedation Scales for Neonatal and Pediatric Patients in a Preverbal Stage of Development

Consistency of pediatric pain ratings between dyads: an updated meta-analysis and metaregression

How codeine metabolism affects its clinical use

Contact Info

Product

Resources

About