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Santervas Y.F.,Hospital Universitari Of Sant Joan Of Deu
European journal of emergency medicine : official journal of the European Society for Emergency Medicine | Year: 2010

The objective of this study is to assess the impact of various actions in the management of pain in a pediatric hospital emergency department. This is an observational study, preaction (phase 1) and postaction (phase 2), with two cohorts of patients diagnosed with abdominal pain, chest pain, and severe headache. Between the two phases, various actions were carried out (distribution of pain assessment scales and a new guide for the management of pain, and the holding of clinical training sessions). Three hundred patients were included in the study, with an average age of 9 years and average evolution time of pain of 20&x2009;h. Pain assessment in phases 1 and 2 was 30 and 99.3%, respectively. Analgesics were administered to 23% (phase 1) and 38.6% (phase 2) of the patients with pain. No side-effects from the analgesics given were recorded. In conclusion, the various actions carried out yielded an improvement in pain management, especially in its assessment.

Corniero P.,Hospital Universitari Of Sant Joan Of Deu | Gamell A.,Hospital Universitari Of Sant Joan Of Deu | Parra Cotanda C.,Hospital Universitari Of Sant Joan Of Deu | Trenchs V.,Hospital Universitari Of Sant Joan Of Deu | Cubells C.L.,Hospital Universitari Of Sant Joan Of Deu
Pediatric Emergency Care | Year: 2011

Objectives: Family presence (FP) during invasive procedures (IPs) in children remains controversial among pediatric emergency department (PED) staff. The authors aimed to determine health care providers' attitudes toward FP during IPs in Spain, to learn whether parents are given the option of being present during different IPs, and to study which factors influence the providers' opinions. Methods: Observational study. Physicians and nurses were asked to answer a questionnaire, which was sent to 43 PEDs and was available at the Spanish Pediatric Emergency Society Web site. Results: We obtained 222 questionnaires from 36 Spanish hospitals. A total of 65.8% of the surveys were answered by physicians (66.4% pediatricians) and 34.2% by nurses. The median age of the respondents was 32 years, and 69.2% were women. Parents were given the option of being present during blood sampling (36.4%), intravenous line placement (32.7%), urethral catheterization (32.1%), lumbar puncture (13.5%), and resuscitation (1%). More than 60% of providers approved of FP during blood sampling, sutures, intravenous line placement, and urethral catheterization; however, only 10.8% of providers encourages FP during resuscitation. Against FP, health care staff argue procedural invasiveness (75.6%), parents' anxiety (87.6%), and worsened performance of the procedure (66%). Commonly expressed advantages were reducing patient distress (72.9%) and parent anxiety (62.3%). Physicians, especially the older ones, are more likely to encourage FP than nurses for some IPs. Conclusions: The PED staff tend to prefer parents not to be present during IPs as the level of invasiveness increases. Family presence is not common in Spanish PEDs. Older physicians are more likely to support FP than nurses. Copyright © 2011 by Lippincott Williams & Wilkins.

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