Pain Passport as a tool to improve analgesic use in children with suspected fractures in emergency departments
10.3344/kjp.2020.33.4.386
- Author:
Soyun HWANG
1
;
Yoo Jin CHOI
;
Jae Yun JUNG
;
Yeongho CHOI
;
Eun Mi HAM
;
Joong Wan PARK
;
Hyuksool KWON
;
Do Kyun KIM
;
Young Ho KWAK
Author Information
1. Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea
- Publication Type:Clinical Research Article
- From:The Korean Journal of Pain
2020;33(4):386-394
- CountryRepublic of Korea
-
Abstract:
Background:In the emergency department (ED), adequate pain control is essential for managing patients; however, children with pain are known to receive less analgesia than adults with pain. We introduce the Pain Passport to improve pain management in paediatric patients with suspected fractures in the ED.
Methods:This was a before-and-after study. We reviewed the medical records of paediatric patients who were primarily diagnosed with fractures from May to August 2015. After the introduction of the Pain Passport, eligible children were enrolled from May to August 2016. Demographics, analgesic administration rates, time intervals between ED arrival and analgesic administration, and satisfaction scores were obtained. We compared the analgesic prescription rate between the two periods using multiple logistic regression.
Results:A total of 58 patients were analysed. The baseline characteristics of subjects during the two periods were not significantly different. Before the introduction of the Pain Passport, 9 children (31.0%) were given analgesics, while after the introduction of the Pain Passport, a significantly higher percentage of patients (24/29, 82.8%) were treated with analgesics (P < 0.001). The median administration times were 112 (interquartile range [IQR], 64-150) minutes in the pre-intervention period and 24 (IQR, 20-74) minutes in the post-intervention period. The median satisfaction score for the post-intervention period was 4 (IQR, 3-5). The adjusted odds ratio for providing analgesics in the post-intervention period was 25.91 (95% confidence interval, 4.36-154.02).
Conclusions:Patient-centred pain scoring with the Pain Passport improved pain management in patients with suspected fractures in the paediatric ED.
