Pijnbeoordeling bij kinderen op de spoedeisende hulp

Jadav MA, Lloyd G, McLauchlan C, Hayes C. Routine pain scoring does not improve analgesia provision for children in the emergency department. Emerg Med J 2009 Oct;26(10):695-7

Het scoren van pijn zou moeten leiden tot een betere pijnmedicatie bij kinderen die naar de spoedeisende hulp afdeling (SEH) komen. Onze SEH vond dat slechts 75% van de kinderen met pijnlijke verwondingen pijnmedicatie werd aangeboden-36% van hen kreeg een opiaat, terwijl er pijn gescoord werd bij 74%. Dit rapport beschrijft wat er gebeurde toen we probeerden om elk kind een pijnbeoordeling te geven in een poging om pijnbestrijding te verbeteren.

BACKGROUND: Scoring pain should lead to providing better analgesia for children attending the emergency department (ED). Our ED found that it offered analgesia to only 75% of children with painful injuries-36% of them receiving opiates, while scoring pain in 74%. This report describes what happened when we tried to ensure every child had their pain scored in an effort to improve analgesia provision. METHODS: We ensured mandatory pain scoring at triage during the introduction of our computerised notes system, backing this up with extra training of new staff and increased publicity of pain scoring tools. A retrospective audit was conducted after the intervention looking for completion of a pain score, provision of and type of analgesia. The study included children with long bone fractures or partial or full-thickness burns attending the ED. RESULTS: Following the intervention, we found that of 163 children, 97% had their pain scored on a zero-to-10 scale but only 66% received analgesia and only 10% were given opiates. CONCLUSIONS: The intervention was effective at achieving nearly universal early assessment and documentation of pain. This did not translate to an improvement in analgesic provision. Other means of changing behaviour need to be studied, possibly using the computerised record again to obligate analgesia provision

Verwijzing naar het volledige artikel

• Print
• Stuur door
• Delicious