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Observational Study
. 2016 May;105(5):e200-8.
doi: 10.1111/apa.13335. Epub 2016 Feb 12.

Nationwide study of headache pain in Italy shows that pain assessment is still inadequate in paediatric emergency care

Franca Benini  1 , Simone Piga  2 , Tiziana Zangardi  3 , Gianni Messi  4 , Caterina Tomasello  5 , Nicola Pirozzi  5 , Marina Cuttini  6 ; PIPER Study Group
Collaborators, Affiliations
Observational Study

Nationwide study of headache pain in Italy shows that pain assessment is still inadequate in paediatric emergency care

Franca Benini et al. Acta Paediatr. 2016 May.

Abstract

Aim: Italian national guidelines on pain management were published in 2010, but there is little information on how effective pain management is in paediatric emergency care, with other countries reporting poor levels. Using headache as an indicator, we described pain assessment in Italian emergency departments and identified predictors of algometric scale use.

Methods: All Italian paediatric and maternal and child hospitals participated, plus four general hospitals. Data on all children aged 4-14 years admitted during a one-month period with headache as their chief complaint were abstracted from clinical records. Multivariable analyses identified predictors of algometric assessment, taking into account the cluster study design.

Results: We studied 470 admissions. During triage, pain was assessed using a standardised scale (41.5%), informally (15.5%) or was not recorded (42.9%). Only 32.1% of the children received analgesia in the emergency department. The odds ratios for predictors of algometric assessment were non-Italian nationality (3.6), prehospital medication (1.8), admission to a research hospital (7.3) and a more favourable nurses-to-admissions ratio of 10.8 for the highest versus lowest tertile.

Conclusion: Despite national guidelines, paediatric pain assessment in Italian emergency care was suboptimal. Hospital variables appeared to be stronger predictors of adequate assessment than patient characteristics.

Keywords: Child; Emergency care; Headache; Pain assessment; Pain management.

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Figures

Figure 1
Figure 1
Algometric assessment of pain from triage to discharge (n = 470).
Figure 2
Figure 2
Level of pain recorded at triage by type of assessment (informal only versus use of pain rating scales, n. 268).
See this image and copyright information in PMC

References

    1. Cordell WH, Keene KK, Giles BK, Jones JB, Jones JH, Brizendine EJ. The high prevalence of pain in emergency medical care. Am J Emerg Med 2002; 20: 165–9. - PubMed
    1. American Academy of Paediatrics. Committee on Psychosocial Aspects of Child and Family Health; Task Force on Pain in Infants, Children, and Adolescents . The assessment and management of acute pain in infants, children, and adolescents. Paediatrics 2001; 108: 793–7. - PubMed
    1. Fein JA, Zempsky WT, Cravero JP, Committee on Pediatric Emergency Medicine and Section on Anesthesiology and Pain Medicine; American Academy of Paediatrics . Relief of pain and anxiety in paediatric patients in emergency medical systems. Pediatrics 2012; 130: e1391–405. - PubMed
    1. Morton NS. The pain‐free ward: myth or reality. Paediatr Anaesth 2012; 22: 527–9. - PubMed
    1. Cramton REM, Gruchala NE. Managing procedural pain in pediatric patients. Curr Opin Pediatr 2012; 24: 530–8. - PubMed

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