PEDIATRIC PAIN ASSESSMENT PRACTICES AND PREFERENCES OF EMS PROVIDERS

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.Background: Pain scales developed for children were noted not to be useful or practical in an ambulance, and EMS providers have been found to use non‐standardized measures of pain severity in children. A recently published evidence‐based guideline recommends using pictorial scales (PS) for patients aged 4‐12 years, and observational‐behavioral scales (OBS) for younger patients. Objectives were to assess EMS providers’ baseline knowledge, self‐reported practices, self‐efficacy for treating pain in children, and preference for pediatric pain scales. Methods: A survey and education module were administered to a convenience sample of EMS providers from four agencies within a large metropolitan area. Providers answered 20 Likert scale items, received a 15‐minute didactic on pain assessment in children, and then answered four additional survey items. Results: There were 397 surveys returned (80% of providers receiving didactic). Six‐tenths of providers had practiced >10 years, 99% were EMT‐P, and 91% were male. 88% reported feeling “Very‐Extremely” comfortable measuring pain severity in adults; 38% reported the same in children. 57% reported having been trained on the use of pain scales in children; 46% were at least “Moderately” familiar with any PS and 24% with any OBS. While 44% assessed their current practice as “Sometimes‐Always” using pediatric scales,