Validation of the Alder Hey Triage Pain Score

Stewart, Barbara; Lancaster, Gillian; Lawson, J.; Williams, Kim; Daly, Jeanette M.

doi:10.1136/adc.2003.032599

Cited by 40 publications

(44 citation statements)

References 11 publications

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“…Studies that evaluate other oral NSAIDs, including naproxen, in the ED are needed. Based on the results of the systematic review, we can conclude that, for the initial treatment of mild acute pain in children in the ED, it is probably better to administer ibuprofen first, Studied age [16] Score Treatment threshold [22] Psychometric properties a [21] Evidence-based assessment b [142] AHTPS [143] Observational …”

Section: Oral Paracetamol or Non-steroidalmentioning

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: Oral Paracetamol or Non-steroidalmentioning

confidence: 99%

Managing Pediatric Pain in the Emergency Department

Bailey

Trottier

2016

Pediatr Drugs

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“…17 Both of these scales, to the extent that they were validated in these specific contexts, are more appropriate when used exclusively in those situations.…”

Section: Contexts Of Pain Assessmentmentioning

confidence: 99%

“…11 Nevertheless, in the course of this literature review it was found that ordinal scales are also used by trained observers or by the medical and nursing teams to assess child pain. In these cases the following instruments were used: the Objective Pain Scale (OPS), 8 the Faces, Leg, Activity, Cry and Consolability scale (FLACC), 8,[13][14][15] the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS), 8 the Pediatric Pain Profile (PPP), 16 the Alder Hey Triage Pain Score (AHTPS), 17 the Child Facial Coding System (CFCS) 18 and the Non-Communicating Children's Pain Checklist-Revised (NCCPC-R). 19 …”

Section: Measurement Scales Of the Instruments Analyzedmentioning

confidence: 99%

Avaliação do comportamento de crianças em situações de dor: revisão da literatura

Correia¹,

Linhares²

2008

J. Pediatr. (Rio J.)

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Objective: To analyze the scientific production published between 2001 and 2006 describing studies assessing children in painful situations, with a focus on preschool children.Sources: Searches were run for empirical articles indexed in electronic databases using the keywords pain assessment and behavior and their equivalents in Portuguese. Summary of the findings:A total of 33 articles were identified, 18 of which were studies of the psychometric properties of instruments for the measurement of pain, while 11 dealt with the application of such instruments and four were studies of intervention procedures for the relief of pain. Conclusions:The results indicate that more recent literature on the assessment of preschool children's behavior in painful situations is focused on testing the psychometric properties of measurement instruments. Acute pain, especially during surgical procedures, was most often assessed using one-dimensional instruments. Pain in children was most often assessed using facial activity as indicator and intensity as dimension. With relation to assessment of pain in special populations, advances were observed related to assessment of pain in preverbal children or preschool children with special needs.J Pediatr (Rio J). 2008;84(6):477-486: Pain measurement, behavior, preschool.

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“…Six studies were located that evaluated different pain measurement tools in the pediatric ED (Bulloch & Tenenbein, 2002;Crellin, Sullivan, Babl, O'Sullivan, & Hutchinson, 2007;Garra et al, 2009;Schultz et al, 2002;Stewart, Lancaster, Lawson, acute pain assessment associated with chief complaint (Bulloch & Tenenbein, 2002;Garra et al, 2009;Stewart et al, 2004), one study evaluated the psychometric properties of the modified version of the pre-verbal, early verbal, pediatric pain scale (M-PEPPS) via secondary analysis from data collected on pediatric patients 12 months through 84 months however data on the nature of pain whether procedural or as a chief complaint was not identified (Strout and Baumann, 2011). Behavioral Distress (OSBD).…”

Section: Reliability Of Pain Instruments In the Edmentioning

confidence: 99%

An Ethnography of the Culture of Pain in a Non-Pediatric Emergency Department

Cummings¹

2013

Journal of Pediatric Health Care

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Rationale for the Study: Despite the exponential growth in pharmacological and nonpharmacological methods for the treatment of pediatric procedural pain there remains a gap between available interventions and actual practice in the emergency department clinical setting. Researchers have recommended the examination of unit culture since culture is proposed to be a major factor that affects the implementation of pain management practices. Method:Ethnography was employed to gain access to the beliefs and practices of healthcare participants in a Northeastern non-pediatric emergency department. Data were collected for 5 months with over 100 hours of observation. Six key informants were interviewed and 44 pediatric procedural interactions with 27 healthcare providers during the treatment of children two to eight years of age undergoing procedures were observed.Other information gathered included documents from the institution, and pain related information from the patient's medical record. All interviews were recorded and transcribed verbatim. Data were managed using the Ethnograph 6.0 and analyzed using the procedure developed by Leininger and McFarland (2006). Results:Seven major themes with categories were discovered that included assessment, ii procedural pain, treatment of pain, communication related to comfort, fragmentation of care in the emergency department, healthcare provider attitudes, and environmental issues and policies. Conclusion:The results of this study suggest that practice environment of the emergency department and organizational culture exerted a significant degree of influence over healthcare providers' pediatric pain management practices. Nurses' did not use pain measurement tools as they were intended to be used and instead improvised measurement by observing the child's behavior. The management of children during painful procedures consisted of an array of behaviors and practices. The use of physical restraint during painful procedures was a common practice. Participants continue to hold many assumptions and misconceptions about pediatric pain assessment and management. The findings of this study provide insight to the everyday practice of emergency department healthcare providers for pediatric pain in a non-pediatric setting.iii Acknowledgments and Dedication

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Validation of the Alder Hey Triage Pain Score

Cited by 40 publications

References 11 publications

Managing Pediatric Pain in the Emergency Department

Managing Pediatric Pain in the Emergency Department

Avaliação do comportamento de crianças em situações de dor: revisão da literatura

An Ethnography of the Culture of Pain in a Non-Pediatric Emergency Department

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