Maimon Michal S, Marques Linda, Goldman Ran D
Pediatric Research in Emergency Therapeutics Program, Divisions of Pediatric Emergency Medicine and Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
Pediatr Emerg Care. 2007 Apr;23(4):223-6. doi: 10.1097/PEC.0b013e31803f5adc.
To document parental administration of analgesic medication to children with pain from acute limb injury before coming to the emergency department (ED).
Research assistants interviewed parents of children 0 to 18 years old who presented to the ED with acute limb injury, asking about analgesic use before arriving to the ED. Parents were also asked for personal and demographic information. Parents who did not give pharmacological analgesia were asked why they decided not to administer medications. All parents were asked if they will administer analgesia in the future.
A total of 72% of parents administered analgesia (pharmacological or others) to their children. Only 28% of the children received pharmacological analgesics before arriving to the ED. Child's mean age was higher for the group receiving medications, compared with those not receiving medications (99 +/- 50 vs 122 +/- 52 months, respectively; P = 0.005). The main parental concern about analgesic use was of potential masking of the clinical signs and symptoms before being seen by a physician.
Prehospital analgesic administration by parents is mainly nonpharmacological largely because of parental concern of interference with medical assessment or underestimating the child's pain. Parental concern of masking symptoms and parental perception of no pain in a child were significant factors in determining parental comfort level in using pharmacological analgesics.
记录急性肢体损伤疼痛儿童在前往急诊科(ED)之前家长给予镇痛药物的情况。
研究助理对0至18岁因急性肢体损伤前往急诊科就诊的儿童家长进行访谈,询问其在到达急诊科之前的镇痛药物使用情况。还询问了家长的个人和人口统计学信息。未给予药物镇痛的家长被问及不给药的原因。所有家长均被问及未来是否会给予镇痛药物。
共有72%的家长对其孩子使用了镇痛药物(药物或其他方式)。只有28%的儿童在到达急诊科之前接受了药物镇痛。与未接受药物的儿童相比,接受药物治疗组儿童的平均年龄更大(分别为99±50个月和122±52个月;P = 0.005)。家长对使用镇痛药物的主要担忧是在医生诊治之前可能掩盖临床体征和症状。
家长在院前给予的镇痛药物主要是非药物性的,这主要是因为家长担心干扰医疗评估或低估孩子的疼痛。家长对掩盖症状的担忧以及家长认为孩子没有疼痛的看法是决定家长使用药物镇痛舒适度的重要因素。