Ortiz, M.I., López-Zarco, M., Arreola-Bautista, E.J. (2012). Procedural Pain and Anxiety in Pediatric Patients in a Mexican Emergency Department. Journal of Advanced Nursing. 68: 2700-2709.
"In emergency rooms, children often experience unpredictable diagnostic and therapeutic procedural-related pain that can be associated with considerable anxiety.DESIGN: A prospective, descriptive and cross sectional study was conducted to investigate the prevalence of procedures or situations that probably induced anxiety and/or pain in children in an emergency room.METHODS: Procedural pain and anxiety were evaluated in children and adolescents (8-16 years) who were admitted to the emergency department of a paediatric hospital between February-September 2010. Children rated their pain and anxiety using a 100-mm visual analogue scale.RESULTS: A total of 252 children with a mean age of 101 years were evaluated. Four-hundred fifty-nine procedures were completed, with an average of 182 events/child. Of these procedures, 369 (804%) were rated painful and 357 (778%) were rated stressful. The most frequently reported procedural pain or stressful episodes were peripheral catheterization, clinical examination and vascular puncture. Overall, 325% of the painful events were rated severe, 320% were rated moderate and 355% were rated slight. However, 30% of the stressful events were rated severe, 389% were rated moderate and 311% were rated slight. Peripheral catheterization was rated severe in 58 children (339%), moderate in 55 children (322%) and slight in 58 (339%) children.CONCLUSION: This study provides data on common emergency department procedures that cause pain and anxiety in children and young adolescents. Healthcare providers must consider the best psychological and pharmacological interventions to reduce procedural anxiety and pain."