title: Paediatric pain management practice and policies across Alberta emergency departments.
abstract: BACKGROUND
  Many children requiring acute care receive suboptimal analgesia.
  
  
  OBJECTIVE
  To describe paediatric pain management practices and policies in emergency departments (EDs) in Alberta.
  
  
  METHODS
  A descriptive survey was distributed to each of the EDs in Alberta.
  
  
  RESULTS
  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%]).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton; ; Women and Children's Health Research Institute, Edmonton;
authors.forename: Samina
authors.initials: S
authors.lastname: Ali
authors.affiliation: Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton;
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Chambers
authors.affiliation: Department of Pediatrics, Faculty of Medicine, University of Calgary, Calgary, Alberta ; Alberta Children's Hospital Research Institute, Calgary, Alberta.
authors.forename: David W
authors.initials: DW
authors.lastname: Johnson
authors.affiliation: Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton; ; Women and Children's Health Research Institute, Edmonton;
authors.forename: William R
authors.initials: WR
authors.lastname: Craig
authors.affiliation: Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton; ; Women and Children's Health Research Institute, Edmonton;
authors.forename: Amanda S
authors.initials: AS
authors.lastname: Newton
authors.affiliation: Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton;
authors.forename: Ben
authors.initials: B
authors.lastname: Vandermeer
authors.affiliation: Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton; ; Women and Children's Health Research Institute, Edmonton;
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Curtis
keywords: Analgesia; Emergency; Paediatrics; Pain; Survey