Parental perception of the adequacy of pain control in their child after discharge from the emergency department

Abstract

Objective: To determine how well the pain of pediatric patients who are discharged from our emergency department (ED) is managed.

Design: Prospective, observational case series conducted from 9/21/96 to 3/16/97.

Setting: University tertiary care ED with an annual pediatric census of 11,000, consisting of a diverse racial and socioeconomic population.

Patients: Children ages < or = 15 years and discharged from the ED with one of the preselected acute, painful, conditions including fracture, corneal abrasion, ankle sprain with swelling, burn, otitis media with pain at discharge, or exudative pharyngitis.

Study protocol: At time of discharge from the ED, data collectors not involved in the patients' care obtained consent from the patient's parent or guardian and completed data collection that included the final diagnosis and any recommended analgesic. Physicians were blinded to patient enrollment. Parents were phoned 48 hours after ED discharge and asked if they believed their child's pain was adequately controlled at home and if they had sought medical care elsewhere. Data were reported as percentages, and confidence intervals (CI) were calculated.

Results: From a convenience sample of 75 patients, five could not be contacted, leaving 70 for analysis. The mean age was 5.4+/-4.7 years. Sixty-seven parents (96%; 95% CI, 91-100%) believed their child's pain was well controlled, and 67 patients (96%; 95% CI, 91-100%) received an analgesic prescription. Five parents did not administer the prescribed analgesic because they believed their child's pain was controlled without it. No parent sought further medical care for pain medication for their child.

Conclusions: Our pediatric pain management study showed high analgesic use and high parental satisfaction. Lectures and bedside education may be a way to improve pain management in pediatric patients.