Paediatric pain management practice and policies across Alberta emergency departments

• Published in: Paediatrics & child health Vol. 19; no. 4; pp. 190 - 194
• Main Authors: Ali, Samina, Chambers, Andrea L, Johnson, David W, Craig, William R, Newton, Amanda S, Vandermeer, Ben, Curtis, Sarah J
• Format: Journal Article
• Language: English
• Published: England Pulsus Group Inc 01-04-2014
• Subjects: Original; Analgesia; Survey; Pain; Emergency; Paediatrics
• ISSN: 1205-7088; 1918-1485
• DOI: 10.1093/pch/19.4.190

Many children requiring acute care receive suboptimal analgesia.
To describe paediatric pain management practices and policies in emergency departments (EDs) in Alberta.
A descriptive survey was distributed to each of the EDs in Alberta.
A response rate of 67% (72 of 108) was obtained. Seventy-one percent (42 of 59) of EDs reported the use of a pain tool, 29.3% (17 of 58) reported mandatory pain documentation and 16.7% (10 of 60) had nurse-initiated pain protocols. Topical anesthetics were reported to be used for intravenous line insertion by 70.4% of respondents (38 of 54) and for lumbar puncture (LP) by 30.8% (12 of 39). According to respondents, infiltrated anesthetic was used for LP by 69.2% (27 of 39) of respondents, and oral sucrose was used infrequently for urinary catheterization (one of 46 [2.2%]), intravenous line insertion (zero of 54 [0%]) and LP (one of 39 [2.6%]).
Few Alberta EDs use policies and protocols to manage paediatric pain. Noninvasive methods to limit procedural pain are underutilized. Canadian paediatricians must advocate for improved analgesia to narrow this knowledge-to-practice gap.