The predictors, barriers and facilitators to effective management of acute pain in children by emergency medical services: A systematic mixed studies review

Whitley, Gregory, Hemingway, Pippa, Law, Graham , Jones, Arwel, Curtis, Ffion and Siriwardena, Niro (2020) The predictors, barriers and facilitators to effective management of acute pain in children by emergency medical services: A systematic mixed studies review. Journal of Child Health Care . ISSN 367-4935

Full content URL: https://doi.org/10.1177%2F1367493520949427

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The predictors, barriers and facilitators to effective management of acute pain in children by emergency medical services: A systematic mixed studies review
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Abstract

We aimed to identify predictors, barriers and facilitators to effective pre-hospital pain management in children. A segregated systematic mixed studies review was performed. We searched from inception to 30-Jun-2020: MEDLINE, CINAHL Complete, PsycINFO, EMBASE, Web of Science Core Collection and Scopus. Empirical quantitative, qualitative and multi-methods studies of children under 18 years, their relatives or emergency medical service staff were eligible. Two authors independently performed screening and selection, quality assessment, data extraction and quantitative synthesis. Three authors performed thematic synthesis. GRADE and CERQual were used to determine the confidence in cumulative evidence. From 4030 articles screened, 78 were selected for full text review, with 8 quantitative and 5 qualitative studies included. Substantial heterogeneity precluded meta-analysis. Predictors of effective pain management included: “child sex (male)”, “child age (younger)”, “type of pain (traumatic)” and “analgesic administration”. Barriers and facilitators included internal (fear, clinical experience, education and training) and external (relatives, colleagues) influences on the clinician along with child factors (child’s experience of event, pain assessment and management). Confidence in the cumulative evidence was deemed low. Efforts to facilitate analgesic administration should take priority, perhaps utilising the intranasal route. Further research is recommended to explore the experience of the child. Registration: PROSPERO CRD42017058960

Keywords:Ambulance, Analgesia, Children, emergency medical services, Pain
Subjects:B Subjects allied to Medicine > B990 Subjects Allied to Medicine not elsewhere classified
Divisions:College of Social Science > School of Health & Social Care
ID Code:42173
Deposited On:08 Sep 2020 14:30

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