Pain management and sedation for children in the emergency department

doi:10.1136/bmj.b4234

Published 30 October 2009, doi:10.1136/bmj.b4234
Cite this as: BMJ 2009;339:b4234

Clinical Review

Pain management and sedation for children in the emergency department

Paul Atkinson, consultant in emergency medicine , Adam Chesters, specialty registrar in emergency medicine, Peter Heinz, consultant in paediatric medicine

¹ Emergency Department, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge CB2 0QQ

Correspondence to: P Atkinson Paul.atkinson@addenbrookes.nhs.uk

The first 150 words of the full text of this article appear below.

Ensure that children do not experience prolongedor additional pain when presenting for emergency medical care;use a composite assessment tool to assess pain at triage

Aimto provide effective analgesia at the first attempt—usethe appropriate drug, dose, and route; if possible choose painlessmodes of delivery (nasal route, flavoured syrups)

Reassesspain scores frequently to ensure that analgesia is effectiveand allow enough time for it to work

Use pharmacological andnon-pharmacological modalities to manage pain

Avoid the "routine"use of unnecessary painful invasive procedures

Use topical,local, and regional anaesthesia along with appropriate safeprocedural sedation to avoid further pain

Children commonly present for emergency care with painful conditionsand injuries. Further painful, distressing, or unpleasant diagnosticand therapeutic procedures may be necessary during the visit.Emergency clinicians are expected to provide safe and effectiveanalgesia and sedation for children, and provision of such analgesiais a . . . [Full text of this article]

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