scholarly journals Pain management practices surrounding lumbar punctures in children: A survey of Canadian emergency physicians – CORRIGENDUM

CJEM ◽  
2018 ◽  
Vol 21 (5) ◽  
Author(s):  
Naveen Poonai ◽  
Victoria Brzozowski ◽  
Antonia S. Stang ◽  
Amy L. Drendel ◽  
Philippe Boisclair ◽  
...  
Keyword(s):  
Pain Management ◽  
Management Practices ◽  
Emergency Physicians

scholarly journals Pain management practices surrounding lumbar punctures in children: A survey of Canadian emergency physicians

CJEM ◽  
2018 ◽  
Vol 21 (2) ◽  
pp. 199-203 ◽  
Author(s):  
Naveen Poonai ◽  
Victoria Brzozowski ◽  
Antonia S. Stang ◽  
Amy L. Drendel ◽  
Philippe Boisclair ◽  
...  
Keyword(s):  
Pain Management ◽  
Primary Outcome ◽  
Management Practices ◽  
Young Infant ◽  
Pediatric Emergency ◽  
Emergency Physicians ◽  
Emergency Research ◽  
Canadian Association ◽  
Secondary Outcomes ◽  
Specific Barriers

AbstractObjectivesLumbar punctures (LPs) are painful for children, and analgesia is recommended by academic societies. However, less than one-third of pediatric emergency physicians (EPs) adhere to recommendations. We assessed the willingness to provide analgesia among pediatric and general EPs and explored patient and provider-specific barriers.MethodsWe surveyed physicians in the Pediatric Emergency Research Canada (PERC) or Canadian Association of Emergency Physicians (CAEP) databases from May 1 to August 1, 2016, regarding hypothetical scenarios for a 3-week-old infant, a 3-year-old child, and a 16-year-old child requiring an LP. The primary outcome was the willingness to provide analgesia. Secondary outcomes included the type of analgesia, reasons for withholding analgesia, and their perceived competence performing LPs.ResultsFor a 3-week old infant, 123/144 (85.4%) pediatric EPs and 231/262 (88.2%) general EPs reported a willingness to provide analgesia. In contrast, the willingness to provide analgesia was almost universal for a 16-year-old (144/144 [100%] of pediatric EPs and 261/262 [99.6%] of general EPs) and a 3-year-old (142/144 [98.6%] of pediatric EPs and 256/262 [97.7%] of general EPs). For an infant, the most common barrier cited by pediatric EPs was the perception that it produced additional discomfort (13/21, 61.9%). The same reason was cited by general EPs (12/31, 38.7%), along with unfamiliarity surrounding analgesic options (13/31, 41.9%).ConclusionCompared to a preschool child and adolescent, the willingness to provide analgesia for an LP in a young infant is suboptimal among pediatric and general EPs. Misconceptions and the lack of awareness of analgesic options should be targets for practice-changing strategies.

Reported practice variation in pediatric pain management: a survey of Canadian pediatric emergency physicians

CJEM ◽  
2014 ◽  
Vol 16 (05) ◽  
pp. 352-360 ◽  
Author(s):  
Samina Ali ◽  
Andrea Chambers ◽  
David W. Johnson ◽  
Amanda S. Newton ◽  
Ben Vandermeer ◽  
...  
Keyword(s):  
Pain Management ◽  
Management Practices ◽  
Pediatric Emergency ◽  
Practice Variation ◽  
Further Education ◽  
Survey Method ◽  
Emergency Physicians ◽  
Pain Medications ◽  
And Gender ◽  
Almost All

ABSTRACT Objectives: To describe pediatric emergency medicine (PEM) physicians' reported pain management practices across Canada and explore factors that facilitate or hinder pain management. Methods: This study was a prospective survey of Canadian pediatric emergency physicians. The Pediatric Emergency Research Canada physician database was used to identify participants, and a modified Dillman's Total Design Survey Method was used for recruitment. Results: The survey response rate was 68% (139 of 206). Most physicians were 31 to 50 years old (82%) with PEM training (56%) and had been in practice for less than 10 years (55%). Almost all pain screening in emergency departments (EDs) occurred at triage (97%). Twenty-four percent of physicians noted institutionally mandated pain score documentation. Ibuprofen and acetaminophen were commonly prescribed in the ED for mild to moderate pain (88% and 83%, respectively). Over half of urinary catheterizations (60%) and intravenous (53%) starts were performed without any analgesia. The most common nonpharmacologic interventions used for infants and children were pacifiers and distraction, respectively. Training background and gender of physicians affected the likelihood of using nonpharmacologic interventions. Physicians noted time restraints to be the greatest barrier to optimal pain management (55%) and desired improved access to pain medications (32%), better policies and procedures (30%), and further education (25%). Conclusions: When analgesia was reported as provided, ibuprofen and acetaminophen were most commonly used. Both procedural and presenting pain remained suboptimally managed. There is a substantial evidence practice gap in children's ED pain management, highlighting the need for further knowledge translation strategies and policies to support optimal treatment.

scholarly journals Caregiver-Reported Pain Management Practices for Individuals With Cerebral Palsy

2021 ◽  
pp. 100105
Author(s):  
Abagail M. Raiter ◽  
Chantel C. Burkitt ◽  
Alyssa Merbler ◽  
Lisa Lykken ◽  
Frank J. Symons
Keyword(s):  
Cerebral Palsy ◽  
Pain Management ◽  
Management Practices

Pattern of Pain Management Practices of Filipino Surgeons

Oncology ◽  
2008 ◽  
Vol 74 (1) ◽  
pp. 40-45 ◽  
Author(s):  
Jose Rhoel C. de Leon ◽  
Erwin Espinosa
Keyword(s):  
Pain Management ◽  
Management Practices

149 Pain Management Practices in the Emergency Department: 10 Years of Experience in an Academic Center

2011 ◽  
Vol 58 (4) ◽  
pp. S227 ◽  
Author(s):  
O. Cinar ◽  
J. Blankenship ◽  
D. Fosnocht ◽  
J. White ◽  
L. Rogers ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Management Practices ◽  
Years Of Experience ◽  
Academic Center

Neuroprotective Core Measure 5: Minimizing Stress and Pain—Neonatal Pain Management Practices During Heel Lance and Venipuncture in Ontario, Canada

2015 ◽  
Vol 15 (3) ◽  
pp. 116-123 ◽  
Author(s):  
Denise Harrison ◽  
Jessica Reszel ◽  
Jodi Wilding ◽  
Koowsar Abdulla ◽  
Mariana Bueno ◽  
...  
Keyword(s):  
Pain Management ◽  
Management Practices ◽  
Neonatal Pain ◽  
Heel Lance ◽  
Core Measure

A Quality Improvement Project on Pain Management at a Tertiary Pediatric Hospital

2021 ◽  
pp. 084456212110477
Author(s):  
Jodi Wilding ◽  
Hailey Scott ◽  
Victoria Suwalska ◽  
Zarina Geddes ◽  
Carolina Lavin Venegas ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Pain Management ◽  
Chart Review ◽  
Management Practices ◽  
Pain Treatment ◽  
Management Strategies ◽  
Improvement Project ◽  
Pain Scores ◽  
Health Quality ◽  
T1 And T2

To assess and improve pain management practices for hospitalized children in an urban tertiary pediatric teaching hospital. Methods Health Quality Ontario Quality Improvement (QI) framework informed this study. A pre (T1) – post (T2) intervention assessment included chart reviews and children/caregiver surveys to ascertain pain management practices. Information on self-reported pain intensity, painful procedures, pain treatment and satisfaction were obtained from children/caregivers. Documented pain assessment, pain scores, and pharmacological/non-pharmacological pain treatments were collected by chart review. T1 data was fed back to pediatric units to inform their decisions and pain management targets. Results At T1, 51 (58% of eligible participants) children/caregivers participated. At T2, 86 (97%) chart reviews and 51 (54%) children/caregivers surveys were completed. Most children/caregivers at T1 (78%) and T2 (80%) reported moderate to severe pain during their hospitalization. A mean of 2.6 painful procedures were documented in the previous 24 h, with the most common being needle-related procedures at both T1 and T2. Pain management strategies were infrequently used during needle-related procedures at both time points. Conclusion No improvements in pain management as measured by the T1 and T2 data occurred. Findings informed further pain management initiatives in the participating hospital.

scholarly journals Postoperative Pain and Opioid Use Following Surgical Treatment of Ankle Fractures

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0033
Author(s):  
Matthew Pate ◽  
Jacob Hall ◽  
John Anderson ◽  
Donald Bohay ◽  
John Maskill ◽  
...  
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Ankle Fracture ◽  
Management Practices ◽  
Opioid Analgesic ◽  
The United States ◽  
Ankle Fractures ◽  
Opioid Use ◽  
Opioid Prescription ◽  
Opioid Medication

Category: Ankle, Bunion, Trauma Introduction/Purpose: Chronic opioid abuse is one of the greatest public health challenges in the United States. The most common first exposure to opioids comes from acute care prescriptions, such as those after surgery. Moreover, opioids are often prescribed excessively, with current estimates suggesting ˜75% of the pills prescribed are unused. Ankle fractures are the most common operatively treated fracture in orthopaedic surgery, and management of acute pain following surgery is challenging. The optimal perioperative pain regimen is still a point of controversy, as there is limited data available regarding appropriate amount of opioid to prescribe. This study evaluates opioid prescribing techniques of multiple foot and ankle surgeons, and associated patient outcomes. We aim to help surgeons improve their pain management practices and to limit opioid overprescription. Methods: Chart review and phone survey were performed on forty two adult patients within three to six months of ankle fracture fixation at our institution. These patients were offered to voluntarily participate in a standardized questionnaire regarding pain scores, opioid use, non-opioid analgesic use, pain management satisfaction, and patient prescription education. Results: 57% of patients reported that they were given “more” or ”much more” opioid medication than needed, 38% stated that they were given the “right amount”, and 5% reported that they were given ”less” or “much less” than needed. 40.0% were on opioids prior to operation. 53.5% did not require refill of discharge opioid prescriptions, 30.2% of patients did not fill any posteroperative opioid prescription. 16.3% of patients filled their discharge prescription and at least one additionall refill (mean refill = 2.22). Mean number of reported opioid pills taken after surgery was 17.4. Mean satisfaction with overall pain management at phone follow up was 8.6/10. Conclusion: While postoperative pain and management vary substantially, a majority of patients feel that they are given more opioid medication than necessary following ankle fracture repair, and a majority of opioid prescriptions are not completely used. Going forward, it is likely that a majority of patients could experience the same beneficial results with less prescription opioid pain medication, which would reduce overpresciption and potential misuse.

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