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首页> 外文期刊>Canadian Journal of Emergency Medicine >Is caregiver refusal of analgesics a barrier to pediatric emergency pain management? A cross-sectional study in two Canadian centres
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Is caregiver refusal of analgesics a barrier to pediatric emergency pain management? A cross-sectional study in two Canadian centres

机译：护理人员拒绝使用止痛药是否会阻碍小儿急诊疼痛管理？在加拿大两个中心的横断面研究

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ObjectivesThe suboptimal provision of analgesia to children in the emergency department (ED) is well-described. A yet unexplored barrier is caregiver or child refusal of analgesia. We sought to evaluate the frequency of caregiver/child acceptance of analgesia offered in the ED.MethodsWe conducted a two-centre cross-sectional study of 743 caregivers of children 4–17 years presenting to the pediatric ED with an acutely painful condition using a survey and medical record review. The primary outcome was the proportion of children/caregiver pairs who accepted analgesia in the ED.ResultsThe median (IQR) age of children was 11 (7) years, and 339/743 (45.6%) were female. The overall survey response rate was 73% (743/1018). In the 24 hours preceding ED arrival, the median (IQR) maximal pain score rated by children and caregivers was 8/10 (4) and 5/10 (2), respectively, and 30.4% (226/743) of caregivers offered analgesia. In the ED, children reported a median (IQR) pain score of 8/10 (2) and 54.9% (408/743) were offered analgesia. When offered in the ED, analgesia was accepted by 91% (373/408). Overall, 55.7% (414/743) of children received some form of analgesia.ConclusionsMost caregivers/children accept analgesia when offered by ED personnel, suggesting refusal is not a major barrier to optimal management of children’s pain and highlighting the importance of ED personnel in encouraging adequate analgesia. A large proportion of children in pain are not offered analgesia by caregivers or ED personnel. Educational strategies for recognizing and treating pain should be directed at children, caregivers, and ED personnel.
机译：目的急诊科（ED）为儿童提供的镇痛效果欠佳。尚待开发的障碍是看护者或儿童拒绝镇痛。我们试图评估急诊室中看护者/儿童接受镇痛的频率。方法我们通过问卷调查的方式，对向急诊科急诊患儿的ED的4至17岁的743名儿童的743名照护者进行了一项两中心的横断面研究。和病历审查。主要结局是接受急诊镇痛的儿童/看护者对的比例。结果儿童的中位（IQR）年龄为11（7）岁，女性为339/743（45.6％）。总体调查答复率为73％（743/1018）。在急诊室到达之前的24小时内，儿童和护理人员对最大疼痛评分的中位数（IQR）分别为8/10（4）和5/10（2），并且有30.4％（226/743）的护理人员提供了镇痛作用。在急诊室，儿童报告的中位（IQR）疼痛评分为8/10（2），镇痛效果为54.9％（408/743）。在急诊室接受镇痛治疗的比例为91％（373/408）。总的来说，有55.7％（414/743）的儿童接受了某种形式的镇痛。结论大多数护理人员/儿童在急诊人员提供镇痛措施后接受接受镇痛，这表明拒绝接受治疗并不是优化控制儿童疼痛的主要障碍，并强调了急诊人员在以下方面的重要性。鼓励适当的镇痛。照护者或急诊人员不给大部分处于疼痛状态的儿童提供镇痛作用。识别和治疗疼痛的教育策略应针对儿童，看护者和急诊人员。

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