title: Prehospital pain assessment in pediatric trauma.
abstract: OBJECTIVE
  Investigators implemented the current study to analyze the documentation of pain assessments and interventions for injured children in prehospital settings.
  
  
  METHODS
  For this institutional review board-approved retrospective study, 696 Lucas County Emergency Medical Services trauma charts (46% of the county's total runs) from 2002 to 2004 were reviewed, and descriptive statistics of frequency were used to analyze pain-assessment documentation and interventions.
  
  
  RESULTS
  Pain was noted in 64.1% (446/696) of subjects, a statement of "no pain" was noted in 17.2% (120/696) of subjects, and pain was undocumented in 18.7%. Only one trauma chart (1/696, 0.2%) indicated the appropriate use of a validated pain assessment tool (Verbal Rating Scale). There were no documented pain interventions provided to 86.6% (603/696) of all subjects, including 85.0% (379/446) with documented pain. Of all subjects, 13.4% (93/696) received pain interventions. Pharmacological interventions were used for 2.2% (15/696) of all subjects and 16.1% (15/93) of subjects with documented pain interventions. Nonpharmacologic interventions were used in 12.4% of cases (86/696), in which traction and splinting were the most common interventions (36/93, 38.7%), followed by saline flush with dressing (15/93, 16.1%). Diversion and distraction techniques were documented in five charts in which a pain intervention was documented (5/93, 5.4%).
  
  
  CONCLUSIONS
  These results identify a void in the documentation of pain assessment and implementation of pain-control interventions for injured pediatric patients. Education for prehospital providers is recommended, emphasizing the importance of pain assessment and documentation of pain-control care for pediatric trauma patients.
authors: The Toledo Hospital & Toledo Children's Hospital, Toledo, Ohio 43606-3895, USA.
authors: Eugene
authors: E
authors: Izsak
authors: Janet L
authors: JL
authors: Moore
authors: Kathryn
authors: K
authors: Stringfellow
authors: Michael F
authors: MF
authors: Oswanski
authors: David A
authors: DA
authors: Lindstrom
authors: Heather A
authors: HA
authors: Stombaugh
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D010147:Pain Measurement; D010372:Pediatrics; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000503:physiopathology*