Analgesic use in the emergency department

Area of Science:

• Emergency Medicine
• Pediatric Pain Management
• Clinical Outcomes

Background:

• Pain relief is a primary reason for emergency department (ED) visits.
• Disparities in analgesic treatment between pediatric and adult patients are suspected.
• Acute painful conditions include sickle cell crises, fractures, and burns.

Purpose of the Study:

• To compare analgesic treatment in children versus adults with similar acute painful conditions.
• To identify potential disparities in pain management within the ED setting.
• To inform educational needs for healthcare providers regarding pediatric pain.

Main Methods:

• Retrospective chart review of 112 pediatric and 156 adult patients.
• Inclusion criteria: acute pain from sickle cell crises, lower-extremity fractures, or burns.
• Data collected on analgesic administration during ED visit and at discharge.

Main Results:

• 60% of all patients received no pain medication in the ED.
• Children (≤19 years) were significantly less likely to receive analgesics than adults (P = .001).
• Young children (<2 years) received analgesics less often than older children (P < .01).
• 55% of patients were discharged without prescribed pain medication; children were less likely to receive them (P < .001).

Conclusions:

• Pediatricians and emergency physicians demonstrate reluctance in administering analgesics to children in pain.
• Significant disparities exist in ED pain management between pediatric and adult populations.
• Enhanced education is needed for clinicians on the effective management of acute pediatric pain.