Emergency analgesia in the paediatric population. Part I Current practice and perspectives

Maurice, S; O'Donnell, J J; Beattie, T F

doi:10.1136/emj.19.1.4

Cited by 32 publications

(19 citation statements)

References 35 publications

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“…1 While intravenous (IV) administration of opioids has been traditionally used for moderate to severe pain, in recent years there has been exploration of alternative techniques for providing rapid and effective analgesia. 2 Intranasal (IN) analgesic drug delivery has gained momentum in the pediatric world due to its ease of use and wide patient acceptance, with potency and rapidity of onset equivalent to IV morphine.…”

mentioning

confidence: 99%

The Implementation of Intranasal Fentanyl for Children in a Mixed Adult and Pediatric Emergency Department Reduces Time to Analgesic Administration

Holdgate

Cao

2010

Academic Emergency Medicine

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ACADEMIC EMERGENCY MEDICINE 2010; 17:1–4 © 2010 by the Society for Academic Emergency MedicineAbstractObjectives: The objective was to determine whether the introduction of intranasal (IN) fentanyl for children with acute pain would reduce the time to analgesic administration in a mixed adult and pediatric emergency department (ED).Methods: A protocol for IN fentanyl (1.5 μg/kg) for children age 1–15 years presenting with acute pain was introduced to the department. All children who received intravenous (IV) morphine in the 7 months prior to the introduction of the protocol and either IV morphine or IN fentanyl in the 7 months after the introduction of the protocol were identified from drug registers. Time to analgesic administration, time to see a doctor, and the ages of patients were compared between the periods before and after the introduction of IN fentanyl.Results: Following implementation, 81 patients received IN fentanyl and 37 received IV morphine, compared to 63 patients receiving morphine in the previous 7 months. The median time to analgesic administration for IN fentanyl was significantly shorter than for morphine (32 minutes vs. 63 minutes, p = 0.001). Children receiving fentanyl were significantly younger than those receiving morphine (median = 8.5 years vs. 12 years, p < 0.001).Conclusions: This study demonstrates that children treated with IN fentanyl received analgesic medication faster than those treated with IV morphine in a mixed ED. Younger children were more likely to receive opioid analgesia following the introduction of fentanyl.

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confidence: 99%

The Implementation of Intranasal Fentanyl for Children in a Mixed Adult and Pediatric Emergency Department Reduces Time to Analgesic Administration

Holdgate

Cao

2010

Academic Emergency Medicine

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“…Although some feel that doctors and nurses are best placed to estimate children's pain, studies of concordance between physicians' and patients' perceived need for analgesia have shown poor agreement in adults with abdominal pain. Assessment by parents of their child's pain also correlates poorly with the patient's own perceived pain intensity 18–20 . For these reasons, self‐reported pain scales are generally preferred 21,22 .…”

Section: Discussionmentioning

confidence: 99%

Pain score documentation and analgesia: A comparison of children and adults with appendicitis

Furyk

Sumner

2008

Emerg Medicine Australasia

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“…Furthermore, in the case of paraplegic patients [16], whole body movement is not available, significantly hindering the use of [9,10]. Facial expression is also particularly important for measuring pain in pediatrics [17][18][19][20], is one of the key elements of Behavioural Pain Assessment [21] and is a significant part of pain measurement in general [22][23][24][25].…”

Section: Introductionmentioning

confidence: 99%

Measuring facial grimacing for quantifying patient agitation in critical care

Becouze

Hann

Chase

2007

Computer Methods and Programs in Biomedicine

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The effective delivery of sedation in critical care relies primarily on an accurate and consistent measure of a patient's agitation level. However, current methods for assessing agitation are subjective and prone to error, often leading to over sedation or cycles between agitation and oversedation. This paper builds on previous work developing agitation sensors based on heart rate and blood pressure variability, and overall whole body motion. In this research, the focus is on real-time measurement of high resolution facial changes that are observed to occur in agitation. An algorithm is developed that measures the degree of facial grimacing from a single digital camera.The method is demonstrated on simulated patient facial motion to prove the concept.A consistent measure is obtained that is robust to significant random head movement and compares well against visual observation of different levels of grimacing. The method provides a basis for clinical validation.

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Emergency analgesia in the paediatric population. Part I Current practice and perspectives

Cited by 32 publications

References 35 publications

The Implementation of Intranasal Fentanyl for Children in a Mixed Adult and Pediatric Emergency Department Reduces Time to Analgesic Administration

The Implementation of Intranasal Fentanyl for Children in a Mixed Adult and Pediatric Emergency Department Reduces Time to Analgesic Administration

Pain score documentation and analgesia: A comparison of children and adults with appendicitis

Measuring facial grimacing for quantifying patient agitation in critical care

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