Abstract
Background
Paediatric pain is a common reason for emergency department (ED) presentation, yet pain assessment and management remain inconsistent despite the availability of evidence-based interventions. Limited data exist on clinicians’ perspectives regarding barriers to optimal paediatric pain care.
Methods
We conducted a monocentric cross-sectional survey among physicians and nurses working in a tertiary-care ED. The questionnaire assessed paediatric pain assessment practices, pharmacological and non-pharmacological management, procedural analgesia, clinician confidence, and perceived barriers. Quantitative data were analysed descriptively and by subgroup comparison.
Results
Of 225 eligible staff members, 108 responded (48% response rate), and 87 completed questionnaires were included (38.7% inclusion rate). While 91% of respondents reported routinely assessing pain at presentation, only 18% consistently reassessed pain after interventions or procedures. Familiarity with paediatric-specific pain scales was limited, with only 10% and 7% reporting use of the Wong–Baker FACES and FLACC scales, respectively. Only 16% of participants reported high confidence in paediatric analgesic administration, whereas lack of formal training was identified as the most important barrier (47%). Procedural pain management showed substantial variability; 52% of respondents reported no analgesia or anxiolysis during bladder catheterization, and 46% reported none during cast application. Non-pharmacological interventions, particularly distraction techniques, were widely used and perceived as effective. Most participants emphasized the need for improved training and standardized protocols.
Conclusion
Significant gaps persist in paediatric pain reassessment, clinician confidence, and procedural pain management in the ED. Standardized protocols, targeted education, and multimodal approaches may improve guideline-concordant and child-centred paediatric pain care.