Published online September 1, 2006
PEDIATRICS Vol. 118 No. 3 September 2006, pp. 1321 (doi:10.1542/peds.2006-1351)
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LETTER TO THE EDITOR

Evaluation of Nonpharmacologic Methods of Pain and Anxiety Management for Laceration Repair in the Pediatric Emergency Department

Manu Madhok, MD, MPH
Emergency Medicine

Mindy Teele, BS
Child Life,
Children's Hospital of Minnesota,
Minneapolis, MN 55404

To the Editor.—

We congratulate Sinha et al1 for their much-awaited Ken Graff Young Investigator Grant–funded study "Evaluation of Nonpharmacologic Methods of Pain and Anxiety Management for Laceration Repair in the Pediatric Emergency Department." It brings out the fact that parental perception of pain is different than what is felt by the child, as indicated by Facial Pain Scale scores. Child life services helped reduce situational anxiety in both children and parents and lowered parental perception of pain.

Working in pediatric emergency department (ED), we strive for the best practice, and reducing pain in a safe and effective way is a priority. At our institution, results from the recent NRC+Picker survey identified high problem scores (low satisfaction) in areas of "emotional support" and "ED nurses and doctors addressing child's anxiety/fears." We do utilize the services of child life specialists in the busy hours.

Current literature shows that patient and parent satisfaction are congruous and assessment and treatment of pain and anxiety are key for overall satisfaction,2 and ED patient satisfaction correlates with quality of interaction with ED personnel and resolution of pain.3 The survey study looked at the availability of child life programs in pediatric EDs, and of the 44 hospitals surveyed (92% response rate), only 6 had at least 1 full-time child life personnel, showing underutilization of child life services.4 At our institution, we are conducting a survey study to examine family satisfaction with regards to addressing children's fear and anxiety associated with laceration repair in the presence or absence of child life services. We hope what seems obvious, that is, that the positive impact of child life services in the ED will influence parental satisfaction and their decisions regarding utilization and referral to the ED, which would make a wider financial and social impact and might increase the utilization of child life services in ED.

REFERENCES

  1. Sinha M, Christopher NC, Fenn R, Reeves L. Evaluation of nonpharmacologic methods of pain and anxiety management for laceration repair in the pediatric emergency department. Pediatrics. 2006; 117: 1162–1168[Abstract/Free Full Text]
  2. Magaret ND, Clark TA, Warden CR, Magnusson AR, Hedges JR. Patient satisfaction in the emergency department: a survey of pediatric patients and their parents. Acad Emerg Med. 2002;9 :1379 –1388[CrossRef][Web of Science][Medline]
  3. Dahlquist LM, Busby SM, Slifer KJ, et al. Distraction for children of different ages who undergo repeated needle sticks. J Pediatr Oncol Nurs. 2002;19 :22 –34[Abstract/Free Full Text]
  4. Krebel MS, Clayton C, Graham C. Child life programs in the pediatric emergency department. Pediatr Emerg Care. 1996;12 :13 –15[Web of Science][Medline]
PEDIATRICS (ISSN 1098-4275). ©2006 by the American Academy of Pediatrics

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This Article
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