"Pain Scores Rarely Recorded in Children, Even as Receiving Scores Improves Pain Management: Presented at AAP" By Brian Reid Pediatric patients are significantly less likely than other patients to receive a pain score in the emergency department, according to an analysis of U.S. Centers for Disease Control and Prevention data. The findings were presented here on October 8[th at the American Academy of Pediatrics (AAP) National Conference and Exhibition. Presenter Amy Drendel, DO, MS, Assistant Professor of Pediatrics, Emergency Medicine Section, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, United States, said that previous research showed a link between pain scores and rates of analgesic and opioid use. Dr. Drendel and her colleagues assessed 24,707 pediatric visits recorded in the CDC's National Hospital Ambulatory Medical Care Survey database, which tracked visits from 1997 to 2000. The dataset included only rough data on pain, offering information on whether the pain was mild, moderate or severe, rather than the more robust information available via validated pain scales, she said. The data were collected before the Joint Commission on Accreditation of Healthcare Organizations implemented standards for pain assessment, she said. Results show that pediatric emergency departments were half as likely to report a pain score for a patient, and pain score reporting in children under 4 years of age was particularly low. "Only 45% of kids are getting a pain score," Dr. Drendel said. "There's something about that that's wrong." Patients with a recorded pain score were 1.2 times more likely to receive an analgesic to relieve the pain, and 1.64 times more likely to receive opioids than children who never had a pain score assigned. When a pain score was given, pain drug use increased with increased severity of recorded pain. Particularly disappointing, said Dr. Drendal, was the low rates of pain scores in children presenting with otitis media and pharyngitis, two conditions for which the AAP has urged better pain assessment. Less than 40% of otitis media cases and 43.3% of pharyngitis cases received a pain score in the emergency department. An emphasis on pain reporting can boost pain score reporting, according to a second presentation at the AAP conference on an intervention to integrate the Wong-Bakers FACES Pain Scale, a popular assessment tool that asks children to evaluate their pain along a continuum of cartoon faces showing different levels of pain. Physicians in pediatrics and emergency medicine at New York Presbyterian Hospital/Weill-Cornell Medical Center found that an intervention to integrate the Wong-Bakers FACES Pain Scale led to improved levels of pain assessment. Pain score documentation increased from 7.4% before the intervention to 38.2% after its implementation. "It's about communication," said lead author Carl Kaplan, Fellow, Department of Pediatrics, New York Presbyterian Hospital/Weill-Cornell Medical, New York. "Getting to 100% is our goal." [Presentation title: Pain Assessment for Pediatric Patients in the Emergency Department.] www.docguide.com Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.