Keating Liza, Smith Simon
Consultant Emergency and Intensive Care Medicine Emergency Department, Royal Berkshire NHS Foundation Trust, Reading RG1 5AN.
Consultant Emergency Medicine Emergency Department, John Radcliffe Hospital, Oxford OX3 9DU.
Rev Pain. 2011 Sep;5(3):13-7. doi: 10.1177/204946371100500304.
Acute pain is the reason that the majority of patients present to the emergency department.Failure to adequately treat acute pain in the emergency department has been labelled a public health problem.The College of Emergency Medicine has set standards for the timelines and adequacy in management of pain in both adults and children.Joint Care Quality Commission and College of Emergency Medicine national audit demonstrates the gap between standards and current practice.The new Department of Health clinical quality indicators for emergency medicine do not include a measure of pain.Untreated pain can have short and long term effects, including sensitisation to pain episodes in later life.A range of non-pharmacological and pharmacological interventions have been shown to be effective for procedural pain management in infants and children, and are most effective when used in combination.Developmental changes in pain responses, analgesic response and drug pharmacokinetics need to be taken into account when planning procedural pain management for neonates.Comprehensive evidence based guidelines are available to guide effective procedural pain management in neonates, infants and older children.
急性疼痛是大多数患者前往急诊科就诊的原因。在急诊科未能充分治疗急性疼痛已被视为一个公共卫生问题。急诊医学学院已为成人和儿童疼痛管理的时间线及充分性制定了标准。联合护理质量委员会和急诊医学学院的全国性审计显示了标准与当前实践之间的差距。新的卫生部急诊医学临床质量指标未包括疼痛衡量指标。未治疗的疼痛会产生短期和长期影响，包括对晚年疼痛发作的敏感性增加。一系列非药物和药物干预措施已被证明对婴儿和儿童的程序性疼痛管理有效，并且联合使用时效果最佳。在为新生儿规划程序性疼痛管理时，需要考虑疼痛反应、镇痛反应和药物药代动力学的发育变化。有基于综合证据的指南可指导新生儿、婴儿和大龄儿童进行有效的程序性疼痛管理。
