Pain is defined as an unpleasant emotional and sensory experience associated with bodily harm or with situations that cause fear and anxiety. However, it is often undertreated in pediatric emergency departments. This study aims to assess the effectiveness of sedation-analgesia techniques, level of satisfaction among health care professionals and relatives, and agreement between the satisfaction of health care professionals and relatives.
A cross-sectional design was conducted. Sociodemographic and clinical variables were recorded, together with those for effectiveness using the Face, Legs, Activity, Cry, and Consolability scale and the Wong-Baker FACES scale, and the satisfaction using the 10-point Likert scale. Stata 16.1 was used for data analysis.
A total of 94 procedures were registered. The results suggested that these techniques were effective or mildly effective in only half of the cases. Satisfaction was considered good across the board, and the agreement between health care professionals (ie, pediatric nurses and pediatricians) was considered substantial. However, the agreement between health care professionals and relatives was moderate.
Our results suggested that the adequate management of pain in pediatric emergency departments is still a challenge, despite the availability of international guidelines. Future research lines should be focused on analyzing possible causes of the inefficacy of some sedation-analgesia techniques and the causes of the differences between the perspectives of health care professionals and relatives. These research lines may be useful to improve quality of care and pediatric patient comfort.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Emergency Nursing
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises.Pain. 2020; 161: 1976-1982https://doi.org/10.1097/j.pain.0000000000001939
- Clinical Working Group of Analgesia and Sedation of the Spanish Society for Pediatric Emergencies (SEUP). Pain prevalence among children visiting pediatric emergency departments.Pediatr Emerg Care. 2022; 38: 228-234https://doi.org/10.1097/pec.0000000000002580
- Guidelines for the elective use of conscious sedation, deep sedation, and General Anesthesia in pediatric patients. Committee on Drugs. Section on anesthesiology.Pediatrics. 1985; 76: 317-321https://doi.org/10.1542/peds.76.2.317
- Guidelines for monitoring and management of pediatric patients before, during, and after sedation for diagnostic and therapeutic procedures.Pediatr Dent. 2019; 41: 26E-52Ehttps://doi.org/10.1542/peds.89.6.1110
- Committee on Pediatric Emergency Medicine and Section on Anesthesiology and Pain Medicine; American Academy of Pediatrics. Relief of pain and anxiety in pediatric patients in emergency Medical Systems.Pediatrics. 2012; 130: e1391-e1405https://doi.org/10.1542/peds.2012-2536
- The development of a Consensus Conference on Pediatric Procedural Sedation in the Emergency Department in Italy: from here where to?.Ital J Pediatr. 2020; 46: 57https://doi.org/10.1186/s13052-020-0812-x
- Pediatric procedural sedation and analgesia in the emergency department: surveying the current European practice.Eur J Pediatr. 2021; 180: 1799-1813https://doi.org/10.1007/s00431-021-03930-6
- Efficacy and safety of pediatric procedural sedation outside the operating room.Anesth Pain Med. 2020; 10e106493https://doi.org/10.5812/aapm.106493
- Pain evaluation in the paediatric emergency department: differences in ratings by patients, parents and nurses.Int J Environ Res Public Health. 2022; 19: 2489https://doi.org/10.3390/ijerph19042489
- Nationwide study of headache pain in Italy shows that pain assessment is still inadequate in paediatric emergency care.Acta Paediatr. 2016; 105: e200-e208https://doi.org/10.1111/apa.13335
- The predictors, barriers and facilitators to effective management of acute pain in children by emergency medical services: a systematic mixed studies review.J Child Health Care. 2021; 25: 481-503https://doi.org/10.1177/1367493520949427
- Indicadores de calidad SEUP.Ergon Creación, 2018https://seup.org/pdf_public/gt/mejora_indicadores.pdfDate accessed: June 1, 2020
- Documento de consenso: Competencias y Capacitación Del Personal Que Realiza Procedimientos de Sedoanalgesia (PSA).Sociedad Española De Urgencias De Pediatría, 2020https://seup.org/pdf_public/gt/Analg_Consenso_Competencias_capacitac_persona_real_PSA.pdfDate accessed: April 15, 2022
- Protocolos diagnosticos y terapeuticos en urgencias pediátricas.Sociedad Española De Urgencias De Pediatría., 2019 (Published online on September 2020)https://seup.org/pdf_public/pub/protocolos/27_Psedoanalgesia.pdfDate accessed: August 23, 2021
- Manejo del dolor en urgencias pediátricas.Sociedad Española de Urgencias de Pediatría, 2019 (Published online on April 2021)https://seup.org/pdf_public/pub/protocolos/28_Dolor_urgencia.pdfDate accessed: May 25, 2021
- en representación del Grupo de Analgesia y Sedación de la Sociedad Española de Urgencias de Pediatría. Efficacy, safety and satisfaction of sedation-analgesia in Spanish emergency departments. Article in Spanish.An Pediatr (Engl Ed). 2019; 90: 32-41https://doi.org/10.1016/j.anpedi.2018.03.001
- Preparación de los procedimientos de sedoanalgesia en los servicios de urgencias pediátricos españoles: estudio descriptivo.An Pediatría. 2018; 89: 24-31https://doi.org/10.1016/j.anpedi.2017.06.006
- Pediatric procedural sedation in the emergency setting.Plast Reconstr Surg Glob Open. 2020; 8e2735https://doi.org/10.1097/GOX.0000000000002735
- Impact of young age on outcomes of emergency department procedural sedation.Am J Emerg Med. 2021; 46: 116-120https://doi.org/10.1016/j.ajem.2021.03.014
- Paediatric procedural sedation within the emergency department.J Paediatr Child Health. 2016; 52: 197-203https://doi.org/10.1111/jpc.13081
- The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies.Int J Surg. 2014; 12: 1495-1499https://doi.org/10.1016/j.ijsu.2014.07.013l
- Determinación del tamaño muestral.1996 (Accessed June 10, 2021)
- Analysis of the validation of existing behavioral pain and distress scales for use in the procedural setting.Paediatr Anaesth. 2007; 17: 720-733https://doi.org/10.1111/j.1460-9592.2007.02218.x
- Comparison of the psychometric properties of the FLACC scale, the MBPS and the observer applied visual analogue scale used to assess procedural pain.J Pain Res. 2021; 14: 881-892https://doi.org/10.2147/JPR.S267839
- Evidence-based survey design: the use of a midpoint on the Likert scale.Perform Improv. 2017; 56: 15-23https://doi.org/10.1002/pfi.21727
- Pain in children: comparison of assessment scales.Pediatr Nurs. 1988; 14: 9-17
- Validation of the Wong-Baker FACES pain rating scale in pediatric emergency department patients.Acad Emerg Med. 2010; 17: 50-54https://doi.org/10.1111/j.1553-2712.2009.00620.x
Martínez MM, Romero MA, Lorente SS. Sedoanalgesia en urgencias de pediatría: una visión de enfermería. Urgencias en Pediatr. Accessed June 8, 2021. https://seup.org/pdf_public/revistas/vol16_n1.pdf
- Basic statistical reporting for articles published in Biomedical Journals: the “Statistical Analyses and Methods in the Published Literature” or the SAMPL Guidelines.Int J Nurs Stud. 2015; 52: 5-9https://doi.org/10.1016/j.ijnurstu.2014.09.006
- Handbook of Inter-rater Reliability: The Definitive Guide to Measuring the Extent of Agreement Among Raters.4th ed. Advanced Analytics, LLC, 2014: 163-180
- Computing Krippendorff’s alpha-reliability.Dep Pap., 2011 (Accessed December 29, 2021.)
- Pediátricos Indicadores para medir los criterios de calidad de la atención sanitaria.Sociedad Española De Urgencias De Pediatría, 2001 (Accessed December 29, 2021.)https://docplayer.es/2540931-Pediatricos-indicadores-para-medir-los-criterios-de-calidad-de-la-atencion-sanitaria-sociedad-espanola-de-urgencias-de-pediatria.html
- en representación del Grupo de Analgesia y Sedación de la Sociedad Española de Urgencias de Pediatría. Preparación de los procedimientos de sedoanalgesia en los servicios de urgencias pediátricos españoles: estudio descriptivo.An Pediatr (Engl Ed). 2018; 89: 24-31https://doi.org/10.1016/j.anpedi.2017.06.006
- The art of comfort care.Image J Nurs Sch. 1995; 27: 287-289https://doi.org/10.1111/j.1547-5069.1995.tb00889.x
- A taxonomic structure for the concept comfort.Image J Nurs Sch. 1991; 23: 237-240https://doi.org/10.1111/j.1547-5069.1991.tb00678.x
- Managing acute pain in children presenting to the emergency department without opioids.J Am Coll Emerg Physicians Open. 2022; 3e12664https://doi.org/10.1002/emp2.12664
Sonia Lorente is a Pediatric Nurse, Pediatric Department, Hospital de Terrassa, Consorci Sanitari de Terrassa; and an Adjunct Lecturer, Department of Psychobiology and Methodology in Health Sciences, Autonomous University of Barcelona, Barcelona, Spain. Twitter: @slorente2000. ORCID identifier: https://orcid.org/0000-0002-5494-3325.
Ana Romero is a Pediatric Nurse, Pediatric Department, Hospital de Terrassa, Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain.
Milaydis Martínez is a Pediatric Nurse, Pediatric Department, Hospital de Terrassa, Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain.
Abel Martínez-Mejías is a Pediatrician, Pediatric Department, Hospital de Terrassa, Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain. ORCID identifier: https://orcid.org/0000-0003-4437-4963.
Published online: November 12, 2022
© 2022 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.