The utilization of pain assessment tools in pediatric emergency for better pain management

Objective: Accurate assessment of acute pain in children is essential for effective emergency care but can be challenging due to varying pain expressions across ages. Our study aims to examine healthcare providers’ efforts to enhance assessment using age-appropriate tools. Methods: Patients were retrospectively selected from the King Abdulaziz University Hospital Emergency records which involved a cohort review of 157 children presented to the pediatric emergency department with acute pain from 2017 to 2018. Routine pain assessment tool grading acute pain as mild, moderate, severe by qualified pediatric emergency doctors, Canadian triage acuity scale (CTAS) and numerical rating scale (NRS) were used to describe pain intensity. Inter-statistical cohort analysis was used. Results: The mean age of patients were 8±3.3 years (range: 2.5-13.9 years) with 73 girls and 84 boys. About 80% (n=126) of the children presented to the emergency department with acute pain were scored as CTAS 2-3. All triaged patients passed to the emergency department were assessed as mild (n=66, 42%), moderate (n=27, 17%) and severe (n=35, 22%) pain. The NRS scoring was used in only 12 (7.6%) children as NRS only applies to older children. Paracetamol and nonsteroidal anti-inflammatory drug (NSAID) were the most frequent analgesia administered by the health care providers. There was a statistically insignificant relationship between the severity of the pain and the type of analgesia (P value>0.05). Children with mild pain had a significantly higher level of NSAID administration than those with moderate or severe pain (P<0.05). Children with mild pain had a significantly higher level of NSAID administration than those with moderate or severe pain (P<0.05). Conclusion: Pain assessment with scoring methods like CTAS or NRS in the emergency room (ER) is crucial despite challenges. Inconsistent use affects outcomes, emphasizing the need for research to encourage consistent application in pediatric emergency care.