Results The response rate was 81% (n=17). Of these, 71% (n=12) “often” or “sometimes” use physical restrain of children during procedures. Paediatric sedation is only possible in 29% of the EDs (n= 5). 29% (n=5) of the leading nurses stated that they at least once a month found there is a need for procedural sedation that their department is unable to provide. The three most commonly mentioned reasons for less than optimal pain management in the ER are: lack of subject specific education among the nursing staff of the EDs (71%, n=12) and lack of training among the doctors on call in the EDs on paediatric procedural sedation (53%, n=9) as well as a need for local guidelines on the subject (41%, n=7).