A pediatric patients' pain evaluation in the emergency unit.

AimsHelsinki University Hospital for Children and Adolescents treats 0-to 16-year old pediatric and surgical patients. The patients arrive to the emergency unit by ambulance, referral or by decision of the triage nurse. The most common reason for visit is pain. VAS pain scale should be used, but pain is not evaluated properly. The aim of this study was to review literature on evaluation and treatment of pain in pediatric emergency unit. MethodsA search from Cinahl and Finnish Medic-database covering last 10 years was performed using: pain, child, trauma, documentation, evaluation, emergency and assessment as keywords. ResultsMultiple pain scales are used in pediatric emergency units. A scale possibly useful for us is the CEM, College of Emergency Medicine tool. Non-medical procedural pain treatment: physical methods (e.g. cold, warm, massage), emotional support and cognitive-behavioral methods (e.g. relaxation, mental imagery and information) was found to be as useful in children. The aim of cognitive-behavioral methods is to decrease fear, stress and pain and improve self-determination. Non-medical treatment was found to be cost efficient and decrease the need of analgesics. It was also found that a child in pain should be raised in triage. Educated staff usually means that children get pain medication quicker. ConclusionsResearch on the effects of systematic use of a pain scales on pain treatment, pain and fear in pediatric patients would be interesting.