Ali Samina, Chambers Andrea L, Johnson David W, Craig William R, Newton Amanda S, Vandermeer Ben, Curtis Sarah J
Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton; ; Women and Children's Health Research Institute, Edmonton;
Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton;
Paediatr Child Health. 2014 Apr;19(4):190-4. doi: 10.1093/pch/19.4.190.
Many children requiring acute care receive suboptimal analgesia.
To describe paediatric pain management practices and policies in emergency departments (EDs) in Alberta.
A descriptive survey was distributed to each of the EDs in Alberta.
A response rate of 67% (72 of 108) was obtained. Seventy-one percent (42 of 59) of EDs reported the use of a pain tool, 29.3% (17 of 58) reported mandatory pain documentation and 16.7% (10 of 60) had nurse-initiated pain protocols. Topical anesthetics were reported to be used for intravenous line insertion by 70.4% of respondents (38 of 54) and for lumbar puncture (LP) by 30.8% (12 of 39). According to respondents, infiltrated anesthetic was used for LP by 69.2% (27 of 39) of respondents, and oral sucrose was used infrequently for urinary catheterization (one of 46 [2.2%]), intravenous line insertion (zero of 54 [0%]) and LP (one of 39 [2.6%]).
Few Alberta EDs use policies and protocols to manage paediatric pain. Noninvasive methods to limit procedural pain are underutilized. Canadian paediatricians must advocate for improved analgesia to narrow this knowledge-to-practice gap.
许多需要急症护理的儿童接受的镇痛效果欠佳。
描述艾伯塔省急诊科的儿科疼痛管理实践与政策。
向艾伯塔省的每个急诊科发放了一份描述性调查问卷。
获得了67%（108份中的72份）的回复率。71%（59份中的42份）的急诊科报告使用了疼痛评估工具，29.3%（58份中的17份）报告有强制性疼痛记录，16.7%（60份中的10份）有护士启动的疼痛处理方案。70.4%的受访者（54份中的38份）报告使用局部麻醉剂进行静脉穿刺置管，30.8%（39份中的12份）用于腰椎穿刺（LP）。据受访者称，69.2%（39份中的27份）的受访者使用浸润麻醉剂进行腰椎穿刺，口服蔗糖很少用于导尿（46份中的1份[2.2%]）、静脉穿刺置管（54份中的0份[0%]）和腰椎穿刺（39份中的1份[2.6%]）。
艾伯塔省很少有急诊科使用政策和方案来管理儿科疼痛。限制程序性疼痛的非侵入性方法未得到充分利用。加拿大儿科医生必须倡导改善镇痛措施，以缩小这一知识与实践之间的差距。
