Reuters Health: Kids in non-pediatric ED often get subpar pain management

By Lorraine L. Janeczko

Children in non-pediatric emergency departments (EDs) often don't get adequate pain management, a Canadian study suggests.

"This is the first study to explore pain care for children in a non-pediatric Canadian emergency room (ER) using a validated observational design," the authors wrote in their abstract. "Our results show that pain remains suboptimally managed in our ER despite training given (how to perform pain evaluations and pain care knowledge/attitude), guides of practice, and on-site available pain management protocols."

Rae Ann Kingsley, a nurse practitioner in pain management at Children's Mercy Kansas City in Missouri who was not involved in the Canadian study, told Reuters Health by email, "I applaud the authors for undertaking such a complex observational study and for utilizing the NOTPaM framework to guide the study aims. The findings reveal that improvement for pain assessment and reassessment, utilization of interventions, and therapeutically involving parents, is warranted."

"Children frequently present to non-pediatric ER settings," she noted. "Children in a non-pediatric ER have a right to receive quality pain assessment, intervention, and reassessment."

Morgin Dunleavy, director of nursing in the ED at Children's Mercy Kansas City, said by email, "These findings are not surprising based on the timeframe of the study and the population studied. Winter is a time of higher-than-average volumes for EDs. Managing the increase in ED utilization with no additional resources often leads to increased workloads and less time for nursing to use a holistic approach to care."

"This study is important," added Dunleavy, who also was not involved in the study, "because pain can have lasting negative physiologic and psychological consequences. It is also important because it demonstrates the ineffectiveness of education as a sole strategy in improving patient care."

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