scholarly journals Adolescents’ pain and distress during peripheral intravenous cannulation in a paediatric emergency setting

2021 ◽  
Author(s):  
Giorgio Cozzi ◽  
Marta Cognigni ◽  
Riccardo Busatto ◽  
Veronica Grigoletto ◽  
Manuela Giangreco ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pain Relief ◽  
Local Anaesthesia ◽  
Cross Sectional Study ◽  
Emergency Setting ◽  
Older Children ◽  
Cross Sectional ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency ◽  
Significant Difference

AbstractThe objective of the study is to investigate pain and distress experienced by a group of adolescents and children during peripheral intravenous cannulation in a paediatric emergency department. This cross-sectional study was performed between November 2019 and June 2020 at the paediatric emergency department of the Institute for Maternal and Child Health of Trieste, Italy. Eligible subjects were patients between 4 and 17 years old undergoing intravenous cannulation, split into three groups based on their age: adolescents (13–17 years), older children (8–12 years), and younger children (4–7 years). Procedural distress and pain scores were recorded through validated scales. Data on the use of topical anaesthesia, distraction techniques, and physical or verbal comfort during procedures were also collected. We recruited 136 patients: 63 adolescents, 48 older children, and 25 younger children. There was no statistically significant difference in the median self-reported procedural pain found in adolescents (4; IQR = 2–6) versus older and younger children (5; IQR = 2–8 and 6; IQR = 2–8, respectively). Furthermore, no significant difference was observed in the rate of distress between adolescents (79.4%), older (89.6%), and younger (92.0%) children. Adolescents received significantly fewer pain relief techniques.Conclusion: This study shows that adolescents experience similar pain and pre-procedural distress as younger children during peripheral intravenous cannulation. What is Known:• Topical and local anaesthesia, physical and verbal comfort, and distraction are useful interventions for pain and anxiety management during intravenous cannulation in paediatric settings. • No data is available on pain and distress experienced by adolescents in the specific setting of the emergency department. What is New:• Adolescents experienced high levels of pre-procedural distress in most cases and similar levels of pain and distress when compared to younger patients• The number of pain relief techniques employed during procedures was inversely proportional to patient’s age, topical or local anaesthesia were rarely used

scholarly journals Paediatric Emergency Department preparedness in Nigeria: A prospective cross-sectional study

2020 ◽  
Vol 10 (3) ◽  
pp. 152-158
Author(s):  
Callistus O.A. Enyuma ◽  
Muhammed Moolla ◽  
Feroza Motara ◽  
Gbenga Olorunfemi ◽  
Heike Geduld ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency

scholarly journals A randomized trial of iPad distraction to reduce children’s pain and distress during intravenous cannulation in the paediatric emergency department

2020 ◽  
Author(s):  
Samina Ali ◽  
Keon Ma ◽  
Nadia Dow ◽  
Ben Vandermeer ◽  
Shannon Scott ◽  
...  
Keyword(s):  
Emergency Department ◽  
Standard Care ◽  
Controlled Trial ◽  
Pain Scale ◽  
Emergency Department Visits ◽  
Child Life ◽  
Topical Anesthetic ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency ◽  
Significant Difference

Abstract Objectives We compared the addition of iPad distraction to standard care, versus standard care alone, to manage the pain and distress of intravenous (IV) cannulation. Methods Eighty-five children aged 6 to 11 years requiring IV cannulation (without child life services present) were recruited for a randomized controlled trial from a paediatric emergency department. Primary outcomes were self-reported pain (Faces Pain Scale-Revised [FPS-R]) and distress (Observational Scale of Behavioral Distress-Revised [OSBD-R]), analyzed with two-sample t-tests, Mann–Whitney U-tests, and regression analysis. Results Forty-two children received iPad distraction and 43 standard care; forty (95%) and 35 (81%) received topical anesthesia, respectively (P=0.09). There was no significant difference in procedural pain using an iPad (median [interquartile range]: 2.0 [0.0, 6.0]) in addition to standard care (2.0 [2.0, 6.0]) (P=0.35). There was no significant change from baseline behavioural distress using an iPad (mean ± SD: 0.53 ± 1.19) in addition to standard care (0.43 ± 1.56) (P=0.44). Less total behavioural distress was associated with having prior emergency department visits (odds ratio [95% confidence interval]: −1.90 [−3.37, −0.43]) or being discharged home (−1.78 [−3.04, −0.52]); prior hospitalization was associated with greater distress (1.29 [0.09, 2.49]). Significantly more parents wished to have the same approach in the future in the iPad arm (41 of 41, 100%) compared to standard care (36 of 42, 86%) (P=0.03). Conclusions iPad distraction during IV cannulation in school-aged children was not associated with less pain or distress than standard care alone. The effects of iPad distraction may have been blunted by topical anesthetic cream usage. Clinical trials registration ClinicalTrials.gov: NCT02326623.

scholarly journals Sickle cell disease in Nigerian children: A cross-sectional study on parental awareness and home management of pain

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Oyetundun Fausat Afolabi ◽  
Sabastine Ndubisi Esomonu
Keyword(s):  
Pain Relief ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Maternal Education ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cell Disease ◽  
Cross Sectional ◽  
Parental Awareness ◽  
Significant Difference

Pain, being the clinical trademark of Sickle Cell Disease (SCD), impacts negatively on clinical outcome in children. However, little is known regarding parental home pain management in children with SCD. We aimed to determine the parental awareness, use and perceived efficacy of pain relief techniques for children with SCD. This is a cross-sectional study involving 80 parents of children with SCD seen at General Hospital, Bwari, North-Central Nigeria. An interview-based, structured questionnaire was used to obtain information on socio-demographic characteristics, clinical history, parental awareness, use and perceived effectiveness of pain relief techniques. Data analysis was with SPSS version 20. Seventy-six (95.0%) respondents were aware of available pain relief technique(s) in SCD. Fifty-four (67.5%) respondents used pain relief techniques, 33 (61.1%) of whom used multiple pain relief techniques. The most commonly used drugs and Complementary and Alternative Medicine (CAM) were nonsteroidal anti-inflammatory drugs (47.0%) and massage (36.0%) respectively. Thirty-three (61.1%) respondents perceived their selected techniques as effective. A higher proportion (27.3%) of the children with multiple hospitalizations used multiple pain relief techniques when compared with 4.8% who used drugs alone (p=0.038). However, there was no significant difference based on age, gender, maternal education, genotype, age at diagnosis, pain episodes, regularity of routine drugs and packed cell volume of the children and pain relief techniques used (p>0.05). This study found high parental awareness and utilization of home pain relief techniques for children with SCD. The use of multiple pain relief techniques was influenced by multiple hospitalizations of the children.

scholarly journals Comparing telehealth to traditional office visits for patient management in the COVID-19 pandemic: A cross-sectional study in a respiratory assessment clinic

2021 ◽  
pp. 1357633X2199019
Author(s):  
J Cole Phillips ◽  
Richard W Lord ◽  
Stephen W Davis ◽  
Amanda A Burton ◽  
Julienne K Kirk
Keyword(s):  
Emergency Department ◽  
Hospital Admission ◽  
Primary Outcome ◽  
Office Visit ◽  
Cross Sectional Study ◽  
Office Visits ◽  
Sectional Study ◽  
Cross Sectional ◽  
Significant Difference

Introduction The aim of this study was to examine whether telehealth is as safe and effective as traditional office visits in assessing and treating patients with symptoms consistent with COVID-19. Methods In this retrospective cross-sectional study, the primary outcome was any 14-day related healthcare follow-up event(s). Secondary outcomes were the type of 14-day related follow-up event including hospital admission, emergency department visit, office visit, telehealth visit and/or multiple follow-up visits. Individual visit types were identified due to the significant difference between a hospital admission and an office visit. Logistic regressions were done using the predictors of visit type, age, gender and comorbidities and the primary outcome variable of a related follow-up visit and then by follow-up type: hospital admission, emergency department visit or office visit. Results Of 1305 visits, median age was 42.3 years and 65.8% were female. Traditional office visits accounted for 741 (56.8%) of initial visits, while 564 (43.2%) visits occurred via telehealth. One hundred and forty-six (25.9%) of the telehealth visits resulted in a 14-day related healthcare follow-up visit versus 161 (21.7%) of the office visits (adjusted odds ratio (OR) 1.22, 95% CI 0.94–1.58). Discussion There was no significant difference in related follow-ups of initial telehealth visits compared to initial office visits including no significant difference in hospital admission or emergency department visits. These findings suggest that based on follow up healthcare utilization, telehealth may be a safe and effective option in assessing and treating patients with respiratory symptoms as the COVID-19 pandemic continues.

scholarly journals Parental administration of analgesia to children attending the emergency department with acutely painful conditions.

2020 ◽  
Author(s):  
Tessa Kathleen Daly ◽  
Rory O'Brien ◽  
Adrian Murphy
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Pain Score ◽  
Cross Sectional Study ◽  
Emergency Setting ◽  
Educational Strategies ◽  
Cross Sectional ◽  
Major Barrier ◽  
Included Patient ◽  
Analgesic Administration

Background Acute paediatric pain management is often suboptimal in the emergency setting. There is a paucity of published literature on parental administration of analgesia to children, prior to their arrival at the emergency department (ED). The objective of this study was to describe the prevalence of pre-hospital analgesic administration by parents/guardians of children ≤16 years presenting to ED, with acutely painful conditions. Methods This was a prospective cross-sectional study conducted across two EDs in the South of Ireland with a collective annual attendance of approximately 100,000 patients. A consecutive sample of 400 parents/guardians of children aged between 6 months and 16 years, who were self-referred to ED with acutely painful conditions, were included. Data collected included patient demographics, pain score and analgesia administration. Data was analysed with SPSS software using descriptive and inferential statistics. Results 189/400(47%) children received analgesia from their parents/guardians pre-ED arrival. Factors independently associated with increased parental administration of analgesia were: pain score ≥5/10 53.4%(95%CI 48%-59%) vs ≤4/10 29%(95%CI 21%-38%), children with siblings 49.7%(95%CI 45%-56%) vs without siblings 35.3%(95%CI 24%-47%) and presenting <48 hours from onset of pain 50.1%(95%CI 45%-55%) vs presenting ≥48 hours 30.5%(95%CI 19%-42%). Of the 400 participants, 211(53%) received no analgesia before attending ED. Reasons for parents not administering analgesia included: 62/211(29.4%) did not think the child needed it, 39/211(18.5%) accident did not happen at home, 34/211(16.1%) did not want to mask the presence of the pain, 20/211(9.5%) believed the hospital should give medications, and 18/211(8.5%) afraid it would be wrong/harmful. Conclusions Over half the children presenting to ED, with acutely painful conditions, did not receive adequate or timely pain relief pre-ED arrival, causing avoidable suffering. Parental misconceptions about acute pain management are major barrier to analgesic administration. Educational strategies are required to dispel misconceptions, which may ultimately improve the care for this population.

scholarly journals Immature neutrophils in young febrile infants

2019 ◽  
Vol 104 (9) ◽  
pp. 884-886 ◽  
Author(s):  
Sriram Ramgopal ◽  
Lorne W Walker ◽  
Andrew J Nowalk ◽  
Andrea T Cruz ◽  
Melissa A Vitale
Keyword(s):  
Risk Assessment ◽  
Emergency Department ◽  
Bacterial Meningitis ◽  
Bacterial Infections ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Paediatric Emergency Department

BackgroundTo describe the diagnostic value of the absolute band count (ABC) and ratio of immature to total neutrophils (I:T) for invasive bacterial infections (IBIs; bacterial meningitis and bacteraemia) among young febrile infants.MethodsWe performed a cross-sectional study in a paediatric emergency department of febrile infants ≤60 days over 12 years to evaluate the accuracy of the ABC and I:T for IBI.ResultsOf 2930 included patients, 75 (2.6%) had IBIs. The area under the curve (AUC; 95% CI) for ABC was 0.69 (0.62 to 0.76) with sensitivity 0.27 (0.17 to 0.38) and specificity 0.94 (0.93 to 0.95) at cutoff ≥1500 cells/µL. The AUC for I:T was 0.65 (0.59 to 0.72) with sensitivity 0.29 (0.19 to 0.41) and specificity 0.88 (0.87 to 0.89) at cutoff ≥0.2. Only the ABC in infants 29–60 days was minimally accurate.ConclusionThe ABC and I:T were generally inaccurate for detecting IBI in febrile infants. Guidelines without these parameters may be better for risk assessment.

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