719 Developing Paediatric Pain Maps in the Accident and Emergency Department

Abstract

Background and aims: The College of Emergency Medicine has consistently identified pain score recording as essential in the provision of adequate analgesia in the Paediatric acute care setting. This study recorded patients' stated pain scores in realtime at set defined time points.Methods: A prospective, observational pilot study utilising convenience sampling of children aged 5 - 15 years was conducted in the Ormskirk District General Hospital Paediatric Emergency Department, UK (20,815 presentations pa) 10 - 24th July 2009. Self-reported pain scores in acute pain were recorded every 15 minutes for 4 hours, using a combination of a numeric rating scale from 0-10 and the Wong-Baker FACES pain scale.Results: During the study period 54 patients were enrolled, 7.27 % (n = 743) of the attendances, with 47 completing the 4 hour pain score period.All patients showed a reduction in their pain scores compared to their pain score on presentation. Maximal pain score reduction occurred within 1 hour (varied treatment regimes - medical / nonmedical). Some patients showed secondary peaks in pain towards 4 hours.Conclusions: Mapping patients' pain through sequential pain scoring should provide valuable information to predict intervention responses and in the future may be facilitated by a patient-controlled real-time pain assessment electronic device. In addition we envisage calculating the area under the curve for pain versus time graphs, which may make us re-evaluate moderate pain regimes.