Abstract
BackgroundPain is a common symptom in children and youth attending casualty centres and emergency departments. The aim of this study was to acquire more knowledge about how pain in children is measured and handled by emergency primary care physicians.MethodsA structured questionnaire study was performed among 75 emergency primary care physicians in a Norwegian accident and emergency department (AED). We used descriptive statistics to analyse the use of a pain scale, the use of weight and age when dosing pain medication, the need for more knowledge and the need for pain management procedures in children. The Pearson chi-square test was used to analyse differences between groups.ResultsA pain scale with a visual analogue scale (VAS) had been used by 59 % of physicians in young patients aged 9 to 19 years, by 23 % in children aged 3 to 8 years, and by 3 % in children below 3 years. A total of 63 % of physicians reported that they used the child’s weight instead of the age interval when estimating the needed dose of painkillers. They relied on parents’ weight estimation and seldom measured the child’s weight at attendance. Most emergency medical care physicians reported a need for more knowledge and better procedures related to both pain evaluation and pain treatment in children and youth. The physicians included in the study were demographically representative of AED physicians in Norway (average age 37 years old, 55 % men, 76 % had studied medicine in Norway and 49 % had fewer than 5 years of medical experience).ConclusionsEmergency primary care physicians report a need for pain assessment procedures in children and youth. They sometimes use a pain scale when measuring and managing pain in patients aged 9 to 19 years, but seldom in younger patients.
Highlights
Pain is a common symptom in children and youth attending casualty centres and emergency departments
To make a correct diagnosis, it is important for the physician to evaluate the quality, quantity, location, affective and cognitive aspects and other characteristics related to the pain
Bergen AED is mostly staffed by physicians who are permanent employees or interns, but during evenings and nights, most physicians on call are self-employed general practitioners (GPs) or hospital physicians
Summary
Pain is a common symptom in children and youth attending casualty centres and emergency departments. The aim of this study was to acquire more knowledge about how pain in children is measured and handled by emergency primary care physicians. Pain is the most common symptom in children and youth attending casualty centres and emergency departments whether due to middle ear infections, appendicitis, fractures or wounds [1, 2]. To make a correct diagnosis, it is important for the physician to evaluate the quality, quantity, location, affective and cognitive aspects and other characteristics related to the pain. Pain evaluation is more difficult the younger and less verbally communicative the child is. Inadequate pain management during medical care, especially among very young children, can have detrimental effects [3].
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