PROCEDURAL PAIN IN A PEDIATRIC SURGICAL EMERGENCY UNIT

Pain induced by various types of procedures was assessed in the Paedia tric Surgical Emergency Department at St Goran's Children's Hospital i n Stockholm. Assessments of pain were obtained from the nurse, the par ent, and children over 10 years of age by means of a visual analogue s cale. In children aged 3-9 years, the Smiley Five-Face Scale was used. The nurse and the parent also answered questionnaires about analgesic medication, the child's behaviour, and the parent's overall opinion o f the pain management, etc. Irrigation of the glans penis because of b alanitis, treatment of fractures and paronychia were considered to be the most painful procedures. Forty-four per cent of the children cried during the procedure and 16% fought against being restrained. In 24% of the cases, the child was judged to be in a stale of ''panic''. In c onclusion, we believe that the pain induced by procedures in the emerg ency rooms is unacceptably high. Children estimate higher pain scores than parents and nurses do. There was a poor correlation between the p arent's and child's estimates of pain. Parents are not well informed a bout the possibilities for pain treatment. Infants and children attend ing emergency rooms must also benefit from recent advances in the trea tment of pain.