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For effective and easy pain estimation
in children (younger than 8 years‘ including newborns or
preterm neonates) in
out-of-hospital emergency setting, EVENDOL Score can be considered.
In out-of-hospital emergency medicine, pain in children is
underestimated and undertreated. A reliable pain scale has not been validated
till now in this setting. EVENDOL, is a AA single observational pain scale for
all children younger than 8 years which has been validated in emergency
pediatric units. The practicality of EVENDOL score in an out-of-hospital
emergency setting has been explored in the study portrayed here.
This was an prospective multicenter study which comprised
of all conscious children younger than 8 years. They were transported by a
mobile intensive care unit between October 2008 and May 2010. The emergency
physician and nurse independently estimated the child's pain. They used a
numeric rating scale (score 0-10), then the 5-item EVENDOL scale (verbal/vocal
expression, facial expression, movements, postures, and relationship with
entourage) (score 0-3/item) at 3 time points (at rest, during examination, and
after analgesia). The internal validity,
interrater reliability, discriminant ability (influence of fever and anxiety),
and face validity of the scale was studied upon.
A total of 422 children participated in this study, out of
which 82 and 62 (29%-39%) were in pain according to the emergency physician and
nurses (numeric rating scale >3/10). For all population subsets, all EVENDOL
scale attributes were fulfilled at all 3 time points. The values for the first
estimation (entire study population) obtained were: internal validity
(0.78-0.89), interrater reliability (r = 0.63-0.76, weighted κ = 0.49-0.65),
construct validity, and discriminant ability (r = 0.6-0.7). No change was
observed on the EVENDOL score due to fever. The anxiety level and pain were
correlated. A fast (mean, 2.3-3.4 minutes) completion time and a good face
validity was observed.
It was thus revealed that EVENDOL is a quick, easy-to-use,
discriminant instrument to estimate pain in young children in out-of-hospital
emergency settings.
Pediatr Emerg Care. 2016 Dec 28.
Pain Assessment in Children Younger Than 8 Years in Out-of-Hospital Emergency Medicine: Reliability and Validity of EVENDOL Score
Beltramini A et al.
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