In the emergency department, pain has to be assessed quickly, in order to choose the appropriate analgesic. A simple behavioural scale was needed for young children under 6 years.
Elaboration EVENDOL was elaborated by paediatric pain specialists and emergency staff members. The scale includes five items: complaint, grimace, movements, postures, interaction with surroundings, each scored from 0 to 3.
Validation The scale was tested at three times: before any care, during mobilisation, after analgesic. Construct validity and interrater reliability were studied. Children were assessed by the nurse and the searcher, with EVENDOL and with a visual analogue scale (VAS) and with other scales. Anxiety and asthenia levels were assessed. Self-assessment scores were obtained from children above 4 years of age.
Results 297 children (1 month to 6 years) were included.
Construct Validity Scores before/after nalbuphine varied from 8.14 to 3.62 at rest (p<0.0001), from 11.87 to 6.65 at mobilisation (p = 0.0011); correlations between VAS and EVENDOL: 0.79 to 0.92 at all times (p<0.0001); correlations between EVENDOL and other behavioural pain scales (EDIN, CHEOPS, FLACC, TPPPS): 0.5 to 0.93 (concurrent validity); correlations between FPS-R and EVENDOL in 4–6-year-old children varied between 0.64 and 0.93; correlations between EVENDOL and tiredness and anxiety were bad (0.15 to 0.34) (discriminant validity).
Content Validity Excellent Cronbach coefficient (0.83 to 0.92). Interrater reliability between nurses and researcher: correlations 0.89 to 0.98, weighted kappa 0.7 to 0.9.
Conclusion EVENDOL, a new five-item scale to assess young children’s pain in the emergency department is validated. EVENDOL is simple and well accepted by nurses.