Contributions
Abstract: PB2154
Type: Publication Only
Background
Aims
Here we report our findings following a complete retrospective audit cycle, documenting the timeliness of analgesia administration and post-treatment pain review as per National Institute of Clinical Excellence and College of Emergency Medicine guidelines, in children with SCD presenting to a single inner city London ED over a 14 month period.
Methods
In 2014, we evaluated 48 patient records of children presenting to the ED, with respect to mild, moderate and severe pain scores, time of analgesia administration and pain review. Completing the audit cycle, 97 records were re-audited in 2015. A total of 145 admission records were evaluated.
Results
In 2014 the ED met CEM criteria for the timeliness of analgesia administration in 100% of severe and 95% of the moderate pain category; however fell 33% short of NICE standards. Pain review was poorly performed, identifying an area for improvement. Proportions meeting the aforementioned criteria fell significantly in 2015, except review of moderate pain, which increased by 25%.
Conclusion
We conclude CEM guidelines promote timely administration of analgesia in patients with severe pain; however mild pain may be overlooked. NICE avoids this discrimination. Thus we recommend combining the mild and moderate pain categories to acknowledge the fluctuating nature of sickle pain and its tendency to rapidly escalate. In addition, we reiterate the need for regular pain reviews. This is important in ensuring analgesia is closely titrated to pain level.
Session topic: 25. Sickle cell disease
Keyword(s): Children, Anemia, Sickle cell, Pain
Abstract: PB2154
Type: Publication Only
Background
Aims
Here we report our findings following a complete retrospective audit cycle, documenting the timeliness of analgesia administration and post-treatment pain review as per National Institute of Clinical Excellence and College of Emergency Medicine guidelines, in children with SCD presenting to a single inner city London ED over a 14 month period.
Methods
In 2014, we evaluated 48 patient records of children presenting to the ED, with respect to mild, moderate and severe pain scores, time of analgesia administration and pain review. Completing the audit cycle, 97 records were re-audited in 2015. A total of 145 admission records were evaluated.
Results
In 2014 the ED met CEM criteria for the timeliness of analgesia administration in 100% of severe and 95% of the moderate pain category; however fell 33% short of NICE standards. Pain review was poorly performed, identifying an area for improvement. Proportions meeting the aforementioned criteria fell significantly in 2015, except review of moderate pain, which increased by 25%.
Conclusion
We conclude CEM guidelines promote timely administration of analgesia in patients with severe pain; however mild pain may be overlooked. NICE avoids this discrimination. Thus we recommend combining the mild and moderate pain categories to acknowledge the fluctuating nature of sickle pain and its tendency to rapidly escalate. In addition, we reiterate the need for regular pain reviews. This is important in ensuring analgesia is closely titrated to pain level.
Session topic: 25. Sickle cell disease
Keyword(s): Children, Anemia, Sickle cell, Pain