儿童四肢创伤分诊阶段的评估和疼痛管理。在引入 PIPER 建议后，对儿科急诊室的回顾性分析。

Assessment and pain management during the triage phase of children with extremity trauma. A retrospective analysis in a Pediatric Emergency Room after the introduction of the PIPER recommendations.

机构信息

"Azienda Unità Sanitaria Locale" of Piacenza, Piacenza, Italy .

"Azienda Unità Sanitaria Locale" of Piacenza, Piacenza, Italy - Department of Medicine and Surgery, University of Parma, Piacenza, Italy.

出版信息

Acta Biomed. 2020 Nov 30;91(12-S):e2020006. doi: 10.23750/abm.v91i12-S.10618.

DOI:10.23750/abm.v91i12-S.10618

PMID:33263345

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8023101/

Abstract

BACKGROUND AND AIM OF THE WORK

Pain is one of the most common symptoms in children who access the Pediatric Emergency Room (PER). However, many studies show that it is poorly evaluated and treated during the triage phase and that in many cases algometric scales aren't used for its evaluation. Faced with this, the Piacenza PER (Italy) implemented the Pain in Pediatric Emergency Room (PIPER) recommendations for the assessment and management of pain from the 1st July 2017. The aim of this study was to detect the possible differences in the trend of the outcomes for the detection and treatment of pain in July-October 2016, 2017, 2018.

METHODS

A retrospective observational study was chosen. 811 discharge letters of extremity traumatized children aged 0-9 years were analyzed, of which 309 referred to the 2016 quarter, 243 to the 2017 quarter and 259 to the 2018 quarter.

RESULTS

In 2016, the pain of 12 patients was assessed out of a total of 309, in 2017 of 227 out of 243 and in 2018 of 245 out of 259. The Chi Square test about assessed and not assessed pain, gave statistically significant value (p = 1.36E-98), comparing 2016vs2017 and gave not significant value comparing 2017vs2018 (p = 0.58). 4 patients were treated during the triage phase in 2016, 68 in 2017 and 70 in 2018.

CONCLUSIONS

Recommendations introduction has increased the frequency of pain algometric measurements during the triage phase by leading to an improvement in the nursing care outcomes in terms of pediatric pain management.

摘要

背景与目的

疼痛是儿科急诊（PER）就诊儿童最常见的症状之一。然而，许多研究表明，在分诊阶段疼痛评估和治疗效果不佳，而且在许多情况下，并未使用疼痛评估量表。针对这一情况，意大利皮亚琴扎 PER 自 2017 年 7 月 1 日起实施了《儿科急诊中的疼痛（PIPER）》评估和管理疼痛的建议。本研究旨在检测 2016 年 7 月至 10 月、2017 年 7 月至 10 月和 2018 年 7 月至 10 月期间疼痛检测和治疗结果的趋势差异。

方法

选择回顾性观察性研究。分析了 811 份 0-9 岁肢体创伤儿童的出院记录，其中 309 份来自 2016 年第 1 季度，243 份来自 2017 年第 1 季度，259 份来自 2018 年第 1 季度。

结果

2016 年，309 例患者中评估了 12 例患者的疼痛，2017 年 243 例患者中评估了 227 例，2018 年 259 例患者中评估了 245 例。疼痛评估与未评估的卡方检验具有统计学意义（p=1.36E-98），2016 年与 2017 年比较具有统计学意义，2017 年与 2018 年比较无统计学意义（p=0.58）。2016 年分诊期间有 4 例患者接受治疗，2017 年有 68 例，2018 年有 70 例。