Problemi correnti
Up-date sulla gestione del dolore del bambino in Pronto Soccorso
Up-date of pediatric pain management in emergency units
Franca Benini1, Sabrina Congedi1, Concetta Scalfaro2, Egiodio Barbi3, Alberto Fabio Podestà2, per il Gruppo di Studio PIPER
1Centro di Riferimento Veneto di Terapia del Dolore e Cure Palliative Pediatriche, Università di Padova
2ASST Santi Paolo e Carlo, Ospedale San Carlo Borromeo, Milano
3IRCSS Materno-Infantile “Burlo Garofolo”, Trieste
Gennaio 2019 - pagg. 19 -27
Abstract
Pain is a frequent symptom in paediatric population, especially in the emergency setting;
nevertheless pain is poorly managed in clinical practice. The present paper aims to give
an up-to-date analysis concerning paediatric pain in emergency units, as regards epidemiology,
assessment, measurement and treatment, through a detailed systematic revision
of the literature and an on-going clinical trial assessment carried out by analysing the relevant
data available until March 2018. Among the many paediatric pain scales for different
ages and situations and according to their efficacy and efficiency, FLACC scale,
Wong-Baker scale and FLACC-r or NCCPC-R scale are proposed. Moreover, pharmacological
and non-pharmacological strategies should always be considered; innovative strategies,
new molecules and route of administration allow adequate therapies to be performed
in many clinical situations. Emerging data suggest the need to carry out more research
on pain prophylaxis, increase opioid drugs prescription in case of severe pain and reduce
primary analgesia time. Therefore, an adequate management of pain in paediatric population
in the emergency setting is still a goal to achieve. So, innovative organisational
arrangements, training strategies addressed to health professionals, information and research
are the instruments to imprint a real change in paediatric pain management in
emergency units.
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