Prescription Of analgesia in Emergency Medicine (POEM) secondary analysis: an observational multicentre comparison of pain relief provided to adults and children with an isolated limb fracture and/or dislocation
| Autor: | Liza Keating, Sarah Wilson, Jack R. Dainty, James Robert Sheehan, Jane Quinlan, Sally Beer, Melanie Darwent |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Pain relief Critical Care and Intensive Care Medicine State Medicine Fractures Bone Secondary analysis medicine Humans Pain Management Medical prescription Aged Pain Measurement Aged 80 and over Analgesics business.industry Attendance Limb fracture Extremities General Medicine Emergency department Pain management Middle Aged Cross-Sectional Studies Emergency medicine Emergency Medicine Observational study Female Analgesia business Emergency Service Hospital |
| Popis: | BackgroundAcute pain is a common reason for emergency department (ED) attendance. Royal College of Emergency Medicine (RCEM) pain management audits have shown national variation and room for improvement. Previous evidence suggests that children receive less satisfactory pain management than adults.MethodsPrescription of analgesia in emergency medicine is a cross-sectional observational study of consecutive patients presenting to 12 National Health Service EDs with an isolated long bone fracture and/or dislocation, and was carried out between 2015 and 2017. Using the recommendations in the RCEM Best Practice Guidelines, pain management in ED was assessed for differences of age (adults vs children) and hospital type (children’s vs all patients).ResultsFrom the total 8346 patients, 38% were children (median age 8 years). There was better adherence to the RCEM guidance for children than adults (24% (766/3196) vs 11% (579/5123)) for the combined outcome of timely assessment, pain score and appropriate analgesia. In addition, children were significantly more likely than adults to receive analgesia appropriate to the pain score (of those with a recorded pain score 67% (1168/1744) vs 52% (1238/2361)). Children’s hospitals performed much better across all reported outcomes compared with general hospitals.ConclusionsIn contrast to previous studies, children with a limb fracture/dislocation are more likely than adults to have a pain score documented and to receive appropriate analgesia. Unexpectedly, children’s EDs performed better than general EDs in relation to timely and appropriate analgesia but the reasons for this are not apparent from the present study. |
| Databáze: | OpenAIRE |
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