Predictors of effective management of acute pain in children within a UK ambulance service: A cross-sectional study.
Am J Emerg Med
; 38(7): 1424-1430, 2020 07.
Article
em En
| MEDLINE
| ID: mdl-31864872
ABSTRACT
OBJECTIVE:
We aimed to identify predictors of effective management of acute pain in children in the pre-hospital setting.METHODS:
A retrospective cross-sectional study using electronic clinical records from one large UK ambulance service during 01-Oct-2017 to 30-Sep-2018 was performed using multivariable logistic regression. We included all children <18 years suffering acute pain. Children with a Glasgow Coma Scale score of <15, no documented pain or without a second pain score were excluded. The outcome measure was effective pain management (abolition or reduction of pain by ≥2 out of 10 using the numeric pain rating scale, Wong-Baker FACES® scale or FLACC [face, legs, activity, crying and consolability] scale).RESULTS:
2312 patients were included for analysis. Median (IQR) age was 13 (9-16), 54% were male and the cause of pain was trauma in 66% of cases. Predictors of effective pain management include children who were younger (0-5 years) compared to older (12-17 years) (adjusted odds ratio [AOR] 1.53; 95% confidence interval [CI] 1.18-1.97), administered analgesia (AOR 2.26; CI 1.87-2.73), attended by a paramedic (AOR 1.46; CI 1.19-1.79) or living in an area of low deprivation (index of multiple deprivation [IMD] 8-10) compared to children in an area of high deprivation (IMD 1-3) (AOR 1.37; CI 1.04-1.80). Child sex, type of pain, transport time, non-pharmacological treatments and clinician experience were not significant.CONCLUSION:
These predictors highlight disparity in effective pre-hospital management of acute pain in children. Qualitative research is needed to help explain these findings.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Medição da Dor
/
Serviços Médicos de Emergência
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Manejo da Dor
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article