Paediatric analgesia in an Emergency Department.
Timely management of pain in paediatric patients in the Emergency Department (ED) is a well-accepted performance indicator. We describe an audit of the provision of analgesia for children in an Irish ED and the introduction of a nurse-initiated analgesia protocol in an effort to improve performance. 95 children aged 1-16 presenting consecutively to the ED were included and time from triage to analgesia, and the rate of analgesia provision, were recorded. The results were circulated and a nurse initiated analgesia protocol was introduced. An audit including 145 patients followed this. 55.6% of patients with major fractures received analgesia after a median time of 54 minutes, which improved to 61.1% (p = 0.735) after 7 minutes (p = 0.004). Pain score documentation was very poor throughout, improving only slightly from 0% to 19.3%. No child had a documented pain score, which slightly improved to 19.3%. We recommend other Irish EDs to audit their provision of analgesia for children.
Hawkes
C
C
Cork University Hospital, Wilton, Cork. cphawkes@gmail.com
Kelleher
G
G
Hourihane
J
J
D000293:Adolescent; D000698:Analgesia / Q000379:methods*; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007223:Infant; D007494:Ireland; D008297:Male; D008485:Medical Audit; D010147:Pain Measurement; D010372:Pediatrics; D013997:Time Factors; D014218:Triage