Patient-controlled analgesia for sickle cell pain crisis in a pediatric emergency department. Pediatr Emerg Care 2004 Jan;20(1):2-4
Date
01/13/2004Pubmed ID
14716157DOI
10.1097/01.pec.0000106235.72265.29Scopus ID
2-s2.0-0347763461 (requires institutional sign-in at Scopus site) 45 CitationsAbstract
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.
Author List
Melzer-Lange MD, Walsh-Kelly CM, Lea G, Hillery CA, Scott JPAuthor
Marlene D. Melzer-Lange MD Adjunct Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAnalgesia, Patient-Controlled
Analgesics, Opioid
Anemia, Sickle Cell
Arterial Occlusive Diseases
Child
Child Health Services
Clinical Protocols
Drug Administration Schedule
Emergencies
Emergency Service, Hospital
Episode of Care
Humans
Inpatients
Length of Stay
Pain
Patient Satisfaction
Pilot Projects