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J Korean Soc Emerg Med > Volume 20(2); 2009 > Article
Journal of The Korean Society of Emergency Medicine 2009;20(2): 204-209.
Effectiveness of the Visual Analogue Scale (VAS) as a Method of Pain Measurement in Children and Adolescents who Visit the Pediatric Emergency Department
Sun Ok Je, Eell Ryoo, Jin Joo Kim, Hyuk Jun Yang, Gun Lee, Seong Youn Hwang, Jun Ho Lee
1Department of Emergency Medicine, Gil Hospital, Gachon University, Incheon, Korea.
2Department of Pediatrics, Gil Hospital, Gachon University, Incheon, Korea. ryoo518@gilhospital.com
3Department of Emergency Medicine, Masan Samsung Hospital, Sungkyunkwan University School of Medicine, Masan, Korea.
The aim of this study was to determine the reliability and validity of the Visual Analogue Scale (VAS), as a pain measurement tool in children and adolescents who visit the Pediatric Emergency Department (PED).
This was a prospective, descriptive study, using convenience sampling, of all children between the ages of 5 and 16 years who presented to a PED. The children were excluded who did not cooperate, who altered mentality or sensorium, who were clinically unstable or required admission to the intensive care unit, or who were developmentally delayed. Children were asked to mark their pain severity on the standardized 100-mm VAS, being instructed to slide the marker to the point on the scale that best described their pain. They were also asked to describe their pain as "none", "mild", "moderate", "severe", or "worst".
A total of 716 children and adolescents were enrolled with a mean age of 9.7+/-3.6 years. Males accounted for 439(61.3%). In the children and adolescent who rated their pain as none, (n=10), the mean score was 3.9 mm (95% CI = 0.7 to 7.1); for mild (n=292), the mean score was 30.1 mm (95% CI=28.8 to 31.5); and for moderate pain (n=209) the mean score was 52.4 mm (95% CI=51.2 to 53.6). For those with severe pain (n=187), the mean score was 75.0 mm (95% CI=73.5 to 76.5), and for those who considered their pain the worst (n=18), the mean score was 94.7 mm (95% CI=90.0 to 99.5) (p=0.000). There was no significant relationship between VAS and sex, injury mechanism, or location of pain (p=0.387, p=0.233, p=0.144). The VAS was higher in patients who visited at night on ordinary days (p=0.022) and who were diagnosed with a fracture (71.1+/-20.0 mm) or headache (60.5+/-21.0 mm) (p=0.000). The value was also higher in patients who needed admission (64.9+/-21.5 mm) and an operation (70.7+/-23.0 mm) (p=0.000, p=0.000).
This study demonstrates the quantification via the VAS of pain severity in children and adolescents who visit to the PED. This scale can be used as a tool for triage, pain management, and deriving a prognosis in the PED.
Key words: Pain, Pain measurement, Child
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