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Does age affect analgesia provision at discharge among children with long bone fractures requiring emergency care?
Henry W Ortega1, Heidi Vander Velden, Chia-Wei Lin
1Department of Emergency Services, Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota.
Insights
Young children with long bone fractures received fewer opioid prescriptions at discharge. Age impacts analgesic prescribing patterns for pediatric emergency care, highlighting a need for tailored pain management strategies.
Area of Science:
- Pediatric Emergency Medicine
- Pain Management
- Pharmacology
Background:
- Inadequate pain management in children is a complex issue.
- Pediatric cognitive development variations pose challenges for pain treatment.
- Age-specific approaches are crucial for effective pediatric pain relief.
Purpose of the Study:
- To investigate the influence of patient age on analgesic prescribing at discharge.
- To analyze pain medication patterns for pediatric long bone fractures.
- To assess age-related differences in analgesic provision in emergency departments.
Main Methods:
- Retrospective review of pediatric patients with long bone fractures.
- Data collected from two urban pediatric Emergency Departments (EDs).
- Analysis of prescription patterns for opioid and over-the-counter analgesics at ED discharge.
Main Results:
- Nearly 60% of patients received opioid prescriptions, 19% received OTC analgesics.
- Younger children (<4 years) had lower pain scores and were less likely to receive opioids.
- No significant age differences in opioid prescriptions for severe fractures or OTC analgesic rates.
Conclusions:
- Patient age is a significant factor in analgesic prescribing for pediatric long bone fractures.
- Discharge analgesic patterns differ based on age in pediatric ED patients.
- Age-related variations in pain management require careful consideration in pediatric emergency care.
Background:
Inadequate treatment of painful conditions in children is a significant and complex problem. The wide range of cognitive abilities associated with a child's age is a particular challenge for providers treating children with painful conditions.
Study Objective:
To examine the effect of patient age on the provision of analgesic medicines at discharge in children treated emergently for a long bone fracture.
Methods:
A retrospective review was performed of all patients during a 1-year period with a long bone fracture treated in two urban pediatric Emergency Departments (EDs).
Results:
Eight hundred seventy-eight patients were identified who met our inclusion criteria. Nearly 60% of patients received a prescription for an opioid-containing medicine and 19% received a prescription for an over-the-counter analgesic medicine at ED discharge. Patients younger than 4 years old had lower pain scores, less severe fractures, and overall were significantly less likely to receive an opioid-containing prescription compared to children 4 years old or greater. In children with more severe fractures requiring reduction in the ED, no significant age-related differences were noted in opioid prescription rates. No age-related significant differences were noted for over-the-counter prescription analgesic medicines provided at discharge.
Conclusion:
Young patient age is associated with different analgesic prescription patterns in children treated in the ED for a long bone fracture.
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