Tiadens T., Vervat E., Albertyn R., van Dijk M., van As A.B.S.
Department of Paediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands; Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital, University of Cape Town, Rondebosch, South Africa
Tiadens, T., Department of Paediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands; Vervat, E., Department of Paediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands; Albertyn, R., Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital, University of Cape Town, Rondebosch, South Africa; van Dijk, M., Department of Paediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands; van As, A.B.S., Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital, University of Cape Town, Rondebosch, South Africa
Objectives. To evaluate pain incidence and pain management in a South African paediatric trauma unit, and to compare the usefulness of 5 different assessment tools.Design. A prospective observational study, using the Numerical Rating Scale for pain (NRS pain), Numerical Rating Scale for anxiety (NRS anxiety), the Alder Hey Triage Pain Score (AHTPS), the COMFORT behaviour scale and the Touch Visual Pain Scale (TVPS). All patients were assessed at admission; those who were hospitalised were again assessed every 3 hours until discharge.Results. A total of 165 patients, with a mean age of 5.3 years (range 0 - 13), were included. NRS scores were indicative of moderate to severe pain in 13.3% of the patients, and no pain in 24% at admission. Two-thirds of the patients received no analgesics; for them, NRS pain, AHTPS and TVP scores were lower than the scores for the other children. Conclusion. Pain and anxiety incidences in this paediatric trauma unit are relatively low. Implementation of a standard pain assessment tool in the emergency department triage system can improve pain management. The AHTPS is the most promising for use in non-Western settings.
benzodiazepine; chloral hydrate; codeine; narcotic analgesic agent; paracetamol; adolescent; Alder Hey Triage Pain Score; analgesia; anxiety; article; child; child care; childhood injury; clinical assessment tool; COMFORT behavior scale; comparative effectiveness; controlled study; disease severity; emergency health service; feasibility study; female; human; incidence; infant; interrater reliability; major clinical study; male; Numerical Rating Scale for anxiety; pain; pain assessment; pediatric ward; process design; prospective study; psychometry; rating scale; receiver operating characteristic; scoring system; South Africa; Touch Visual Pain Scale; Adolescent; Analgesics; Chi-Square Distribution; Child; Child, Preschool; Female; Humans; Incidence; Infant; Infant, Newborn; Male; Pain; Pain Measurement; Predictive Value of Tests; Prospective Studies; Reproducibility of Results; Sensitivity and Specificity; South Africa; Triage