Whitley, GA, Hemingway, P, Law, GR et al. (2 more authors) (2020) Predictors of effective management of acute pain in children within a UK ambulance service: A cross-sectional study. The American Journal of Emergency Medicine, 38 (7). pp. 1424-1430. ISSN 0735-6757
Abstract
Objective
We aimed to identify predictors of effective management of acute pain in children in the pre-hospital setting.
Methods
A retrospective cross-sectional study using electronic clinical records from one large UK ambulance service during 01-Oct-2017 to 30-Sep-2018 was performed using multivariable logistic regression. We included all children <18 years suffering acute pain. Children with a Glasgow Coma Scale score of <15, no documented pain or without a second pain score were excluded. The outcome measure was effective pain management (abolition or reduction of pain by ≥2 out of 10 using the numeric pain rating scale, Wong-Baker FACES® scale or FLACC [face, legs, activity, crying and consolability] scale).
Results
2312 patients were included for analysis. Median (IQR) age was 13 (9–16), 54% were male and the cause of pain was trauma in 66% of cases. Predictors of effective pain management include children who were younger (0–5 years) compared to older (12–17 years) (adjusted odds ratio [AOR] 1.53; 95% confidence interval [CI] 1.18–1.97), administered analgesia (AOR 2.26; CI 1.87–2.73), attended by a paramedic (AOR 1.46; CI 1.19–1.79) or living in an area of low deprivation (index of multiple deprivation [IMD] 8–10) compared to children in an area of high deprivation (IMD 1–3) (AOR 1.37; CI 1.04–1.80). Child sex, type of pain, transport time, non-pharmacological treatments and clinician experience were not significant.
Conclusion
These predictors highlight disparity in effective pre-hospital management of acute pain in children. Qualitative research is needed to help explain these findings.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2019, Elsevier. All rights reserved. This is an author produced version of an article published in The American Journal of Emergency Medicine. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Emergency medical services; Ambulances; Infant; Child; Adolescent; Pain |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Psychology (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 11 Nov 2020 11:43 |
Last Modified: | 09 Dec 2020 01:38 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.ajem.2019.11.043 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:167830 |