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Effectiveness of Procedural Sedation and Analgesia in Pediatric Emergencies. A Cross-Sectional Study

Published:November 12, 2022DOI:https://doi.org/10.1016/j.jen.2022.10.004

      Abstract

      Introduction

      Pain is defined as an unpleasant emotional and sensory experience associated with bodily harm or with situations that cause fear and anxiety. However, it is often undertreated in pediatric emergency departments. This study aims to assess the effectiveness of sedation-analgesia techniques, level of satisfaction among health care professionals and relatives, and agreement between the satisfaction of health care professionals and relatives.

      Methods

      A cross-sectional design was conducted. Sociodemographic and clinical variables were recorded, together with those for effectiveness using the Face, Legs, Activity, Cry, and Consolability scale and the Wong-Baker FACES scale, and the satisfaction using the 10-point Likert scale. Stata 16.1 was used for data analysis.

      Results

      A total of 94 procedures were registered. The results suggested that these techniques were effective or mildly effective in only half of the cases. Satisfaction was considered good across the board, and the agreement between health care professionals (ie, pediatric nurses and pediatricians) was considered substantial. However, the agreement between health care professionals and relatives was moderate.

      Discussion

      Our results suggested that the adequate management of pain in pediatric emergency departments is still a challenge, despite the availability of international guidelines. Future research lines should be focused on analyzing possible causes of the inefficacy of some sedation-analgesia techniques and the causes of the differences between the perspectives of health care professionals and relatives. These research lines may be useful to improve quality of care and pediatric patient comfort.

      Key words

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      Biography

      Sonia Lorente is a Pediatric Nurse, Pediatric Department, Hospital de Terrassa, Consorci Sanitari de Terrassa; and an Adjunct Lecturer, Department of Psychobiology and Methodology in Health Sciences, Autonomous University of Barcelona, Barcelona, Spain. Twitter: @slorente2000 . ORCID identifier: https://orcid.org/0000-0002-5494-3325.

      Biography

      Ana Romero is a Pediatric Nurse, Pediatric Department, Hospital de Terrassa, Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain.

      Biography

      Milaydis Martínez is a Pediatric Nurse, Pediatric Department, Hospital de Terrassa, Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain.

      Biography

      Abel Martínez-Mejías is a Pediatrician, Pediatric Department, Hospital de Terrassa, Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain. ORCID identifier: https://orcid.org/0000-0003-4437-4963.