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• W2531317557 abstract "The primary objective was to determine the acute pain level associated with requests for analgesia by children and their parents when pain was assessed by the verbal numeric scale (VNS), the visual analogue scale (VAS), and the verbal rating scale (VRS) in a pediatric emergency department (ED). The secondary objective was to determine agreement between patients and parents for the request for analgesia. A secondary analysis of a prospective cohort study that originally aimed to validate and described the psychometric properties of the VNS used a convenience sample of children aged 8 to 17 presenting to the ED with acute pain of 7 days or less duration. Exclusion criteria were admission to intensive care, intoxicated patients, those with altered mental status, decreased visual acuity or developmental delay. After consent was obtained and pain history collected, patients and their parents were asked to quantify the child’s pain on the VNS (0 to 10), VAS (0 to 10 cm), and VRS (none, mild, moderate or severe, transformed into 0, 1, 2, or 3 for calculation) administered in random order following a predetermined verbatim. They were then questioned on whether analgesia was desired to alleviate the pain. VNS, VAS and VRS pain score for patients and parents who answered “yes” to the request of analgesia were compared to those who answered “no” using a Mann-Whitney test; the 95% confidence interval (CI) for the difference is presented. The agreement between the request for analgesia by children and his/her parent was calculated using the kappa statistic. Over a period of 5 months, 212 patients were assessed for eligibility and 202 were enrolled. Patients had a mean age of 12.2 ± 2.6 years. Main diagnoses at discharge were: 56 fractures (28%), 15 undiagnosed abdominal pain (7%), 15 sprains (7%), 15 contusions (75), and 8 headaches (4%). Pain was considered mild by 41 (20%) patients, moderate by 124 (62%), and severe by 25 (12%). The median [interquartile range (IQR)] levels of pain associated with a request of analgesia and no request for analgesia by the patient were: 6.0 (4.0, 7.4) and 5.0 (3.0, 6.0) [difference of 1.0 (95% CI 0.5, 2.0)] for the VNS; 5.7 (3.9, 7.2) and 4.3 (2.6, 5.8) [difference of 1.3 (95% CI 0.6, 1.9)] for the VAS; and 2.0 (2.0, 2.0) and 2.0 (1.0, 2.0) [a difference of 0.0 (95% CI 0.0, 0.0)] for the VRS. The median (IQR) levels of pain associated with a request for analgesia and no request for analgesia by the parent were: 6.0 (4.0, 7.0) and 5.0 (3.0, 6.0) [a difference of 1.0 (95% CI 0.0, 1.5)] for the VNS; 5.6 (3.9, 7.0) and 4.9 (2.7, 6.1) [a difference of 0.7 (95% CI 0.1, 1.4)] for the VAS; and 2.0 (2.0, 2.0) and 2.0 (1.5, 2.0) [a difference of 0.0 (95% CI 0.0, 0.0)] for the VRS. There was substantial agreement for the request for analgesia by the children and his/her parent with a kappa of 0.67. We determined that children who requested analgesia to alleviate their acute pain had higher pain scores on the VNS and the VAS, than those who did not want analgesia; this difference was not demonstrated by pain measurements with the VRS. We observed that pain scores between the analgesia request categories (“yes” or “no”) could overlap. Given this and that agreement for analgesia requests between children and their parent was only substantial, our findings suggest that children seen in the ED should be asked if they want analgesia to decrease their acute pain instead of relying solely on a pain score or parental requests." @default.
• W2531317557 created "2016-10-21" @default.
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• W2531317557 date "2016-10-01" @default.
• W2531317557 modified "2023-09-26" @default.
• W2531317557 title "185 Request of Analgesia by Patients and Parents for Acute Pain in Children" @default.
• W2531317557 doi "https://doi.org/10.1016/j.annemergmed.2016.08.198" @default.
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