Chan L, Russell T J, Robak N
Department of Emergency Medicine, Albany Medical Center, NY 12208, USA.
Pediatr Emerg Care. 1998 Aug;14(4):251-3. doi: 10.1097/00006565-199808000-00001.
To determine how well the pain of pediatric patients who are discharged from our emergency department (ED) is managed.
Prospective, observational case series conducted from 9/21/96 to 3/16/97.
University tertiary care ED with an annual pediatric census of 11,000, consisting of a diverse racial and socioeconomic population.
Children ages < or = 15 years and discharged from the ED with one of the preselected acute, painful, conditions including fracture, corneal abrasion, ankle sprain with swelling, burn, otitis media with pain at discharge, or exudative pharyngitis.
At time of discharge from the ED, data collectors not involved in the patients' care obtained consent from the patient's parent or guardian and completed data collection that included the final diagnosis and any recommended analgesic. Physicians were blinded to patient enrollment. Parents were phoned 48 hours after ED discharge and asked if they believed their child's pain was adequately controlled at home and if they had sought medical care elsewhere. Data were reported as percentages, and confidence intervals (CI) were calculated.
From a convenience sample of 75 patients, five could not be contacted, leaving 70 for analysis. The mean age was 5.4+/-4.7 years. Sixty-seven parents (96%; 95% CI, 91-100%) believed their child's pain was well controlled, and 67 patients (96%; 95% CI, 91-100%) received an analgesic prescription. Five parents did not administer the prescribed analgesic because they believed their child's pain was controlled without it. No parent sought further medical care for pain medication for their child.
Our pediatric pain management study showed high analgesic use and high parental satisfaction. Lectures and bedside education may be a way to improve pain management in pediatric patients.
确定从我们急诊科（ED）出院的儿科患者的疼痛管理情况。
1996年9月21日至1997年3月16日进行的前瞻性观察病例系列研究。
大学三级护理急诊科，年儿科普查人数为11000人，包括不同种族和社会经济背景的人群。
年龄小于或等于15岁、因以下预先选定的急性疼痛病症之一从急诊科出院的儿童，这些病症包括骨折、角膜擦伤、伴有肿胀的脚踝扭伤、烧伤、出院时伴有疼痛的中耳炎或渗出性咽炎。
在患者从急诊科出院时，未参与患者护理的数据收集人员获得患者父母或监护人的同意，并完成数据收集，包括最终诊断和任何推荐的镇痛药。医生对患者入选情况不知情。在急诊科出院48小时后给家长打电话，询问他们是否认为孩子在家中的疼痛得到了充分控制，以及他们是否在其他地方寻求过医疗护理。数据以百分比形式报告，并计算置信区间（CI）。
从75例患者的便利样本中，有5例无法联系到，剩余70例进行分析。平均年龄为5.4±4.7岁。67位家长（96%；95%CI，91 - 100%）认为孩子的疼痛得到了良好控制，67例患者（96%；95%CI，91 - 100%）接受了镇痛药处方。5位家长未服用处方镇痛药，因为他们认为孩子的疼痛无需用药就能得到控制。没有家长因孩子的疼痛用药而寻求进一步的医疗护理。
我们的儿科疼痛管理研究显示镇痛药使用率高且家长满意度高。讲座和床边教育可能是改善儿科患者疼痛管理的一种方法。
