scholarly journals An assessment of the psychometric properties of the Stoplight Pain Scale in a Canadian paediatric emergency department

2021 ◽  
Author(s):  
Samina Ali ◽  
Ellen Morrison ◽  
Seyara Shwetz ◽  
Maryna Yaskina ◽  
Manasi Rajagopal ◽  
...  
Keyword(s):  
Emergency Department ◽  
Family Involvement ◽  
Pain Scale ◽  
Fair Agreement ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency ◽  
Moderate Agreement ◽  
Repeat Exposure ◽  
Observational Cohort ◽  
Absolute Agreement

Abstract Objective This study aimed to validate a novel, three faced, colour-coded, action-oriented tool: The Stoplight Pain Scale (SPS). Methods A prospective observational cohort study was conducted at a Canadian paediatric emergency department from November 2014 to February 2017. Patients aged 3 to 12 years and their caregivers were asked to rate pain using the SPS and the Faces Pain Scale-Revised (FPS-R). Pain was measured just before analgesia administration, 30 minutes after analgesia administration, and immediately following a painful procedure. Results A total of 227 patients were included; 26.9% (61/227) were 3 to 5 years old while 73.1% (166/227) were 6 to 12 years old. Using Cohen’s κ, agreement for SPS and FPS-R was ‘fair’ for children (0.28 [95% confidence interval {CI} 0.20 to 0.36]) and ‘poor’ for caregivers (0.14 [95% CI 0.07 to 0.21]), at initial measurement. The SPS had ‘fair’ agreement between child and caregiver scores, (0.37 [95% CI 0.27 to 0.47]), compared to FPS-R which showed ‘poor’ agreement (0.20 [95% CI 0.12 to 0.29]). Absolute agreement between child and caregiver SPS scores improved with repeat exposure; 30 minutes after analgesia administration, caregivers and children had fair agreement (κ=0.38, 95% CI 0.28 to 0.48); they had moderate agreement directly following painful procedures (κ=0.46, 95% CI 0.34 to 0.59). Overall, 72.4% (139/192) of children and 60.2% (118/196) of caregivers preferred SPS over FPS-R. Conclusion The SPS demonstrates fair agreement with FPS-R for children and fair-moderate agreement between children and caregivers; agreement improved with repeat use. The SPS is simple and easy to use; it may have a role in empowering direct child and family involvement in pain management.

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 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

Mental health presentations to a paediatric emergency department

2020 ◽  
Author(s):  
Angelo Tolentino ◽  
Linda Symington ◽  
Faye Jordan ◽  
Frances Kinnear ◽  
Mairi Jarvis
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency

scholarly journals 303 What goes bump in the night? A literature review and noise exposure experiment in a UK paediatric emergency department

2020 ◽  
Vol 37 (12) ◽  
pp. 841.1-841
Author(s):  
Lucy Hall ◽  
Sophie Dando ◽  
Anthony Hanks
Keyword(s):  
Emergency Department ◽  
Literature Review ◽  
Literature Search ◽  
Noise Exposure ◽  
Cochrane Library ◽  
Noise Levels ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency ◽  
Sound Levels ◽  
Exposure Experiment

Aims/Objectives/BackgroundIn the Emergency department (ED), noise is a frequent and often unavoidable consequence of work undertaken and levels can often be raised during the day and night. Raised ambient noise levels have potential implications for the workforce, patients and relatives.Investigation into the problem of noise levels in the ED follows feedback from a young patient who couldn’t sleep during a prolonged stay. His complaint focused on loud, irregular banging noises such as those from closing bins that kept him awake.The team felt work should be done to see if it was a wider spread problem or just isolated to his case. A simple sound recording experiment and literature search was conducted.Methods/DesignThe literature search was conducted using electronic/online databases (Medline; Cochrane library) with a fixed date range and specific inclusion criteria.The noise exposure experiment was conducted using a verified phone app to record the sound levels. They were measured at 3 times, during a night shift, in the paediatric emergency department of UHW. All measurements were at a fixed distance and were averaged and compared with WHO recommendations.Results/ConclusionsThere are many sources of noise pollution in the ED, some are unavoidable for safety and clinical reasons.The literature review produced a small number of papers all of which found that sound levels were raised above recommended levels. Similarly, all the sounds measured in the ED also exceeded the recommendations.The most consistent finding across the papers, matched by findings from recordings, was that human behavioural modification is an easy and effective way to reduce noise levels.There are simple steps that can be taken to reduce and eliminate soundsRaising awareness regarding this problem is of great importance and focussing future work on assessing the impact in younger patients within the Emergency Department is paramount.

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