Document Detail


Patient-controlled analgesia for sickle cell pain crisis in a pediatric emergency department.
MedLine Citation:
PMID:  14716157     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether a protocol to start patient-controlled analgesia (PCA) in the emergency department (ED-PCA) would shorten the length of time between narcotic bolus doses and PCA initiation as compared with standard inpatient initiation of PCA (IP-PCA). Also, to compare patient satisfaction and inpatient length of stay for the 2 groups. METHODS: To improve care, we developed a protocol to institute ED-PCA after an initial bolus dose of narcotics. This was a nonrandomized pilot study. Patient records were reviewed for location of PCA initiation, time from narcotic bolus to initiation of PCA, and length of stay. A brief patient/parent satisfaction survey was collected. RESULTS: Sixty-nine records were reviewed. Patients treated using the protocol had initiation of PCA therapy within 35 +/- 7 minutes from the last bolus narcotic dose in the emergency department versus 211 +/- 17 minutes for nonprotocol patients. Forty-eight of 50 patient surveys indicated preference for starting ED-PCA; 2 did not have a preference. No complications were identified in either group. CONCLUSIONS: A protocol to initiate PCA for sickle cell patients in a pediatric emergency department shortened the time of its initiation and was preferred by patients.
Authors:
Marlene D Melzer-Lange; Christine M Walsh-Kelly; Gwen Lea; Cheryl A Hillery; J Paul Scott
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Pediatric emergency care     Volume:  20     ISSN:  1535-1815     ISO Abbreviation:  Pediatr Emerg Care     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2004-01-12     Completed Date:  2004-04-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8507560     Medline TA:  Pediatr Emerg Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2-4     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Children's Hospital of Wisconsin, Milwaukee, WI 53226, USA. mmelzer@mail.mcw.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Analgesia, Patient-Controlled / statistics & numerical data*
Analgesics, Opioid / administration & dosage*,  therapeutic use
Anemia, Sickle Cell / complications*
Arterial Occlusive Diseases / etiology
Child
Child Health Services / organization & administration*
Clinical Protocols
Drug Administration Schedule
Emergencies
Emergency Service, Hospital / organization & administration*
Episode of Care
Humans
Inpatients / psychology
Length of Stay
Pain / drug therapy*,  etiology
Patient Satisfaction
Pilot Projects
Chemical
Reg. No./Substance:
0/Analgesics, Opioid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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