There is evidence that the provision of analgesia for children in emergency departments is often inadequate. Prompt assessment and treatment by nurses could improve matters. In South Australia (Emergency Medicine Journal2005;22:30–2OpenUrlAbstract/FREE Full Text) children with minor or moderate musculoskeletal injuries were studied. Initially, when there was no pain scoring and analgesia provision depended on doctors, the mean time from attendance to receiving analgesia for was 138 minutes and 21% of children received analgesia. After the introduction of pain scoring at triage by nurses the time to provision of oral analgesia fell to 93 minutes (not significant) and 23% of children received analgesia. When nurses both scored pain and provided analgesia, however, the time to analgesia provision fell significantly to 46 minutes and 43% of children were provided with analgesia. The researchers intend to extend their study by measuring whether, or to what extent, the changes actually reduce the pain experienced by these children.

Once the emergency phase is over, refugees in poor countries may have better health provision than the host population. In northern Uganda (Lancet2004; 364:611–2, see also comment, ibid: 562–4OpenUrlCrossRefPubMedWeb of Science) during 1999–2002 maternal mortality was 2.5 times higher in the host population than in the refugee population in postemergency settlements. The refugees had greater access to health care. The authors of this report call upon humanitarian organisations to …