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Improving Quality of Care for Sickle Cell Patients in the Pediatric Emergency Department

Susan M Lin1, John J Strouse, Lauren N Whiteman

  • 1From the *Department of Medicine, and †Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, MD.

Pediatric Emergency Care
|April 4, 2015
PubMed

Insights

Pediatric patients with sickle cell pain crises face treatment delays. Earlier pain management shortens emergency department stays but does not impact overall hospitalization length.

Area of Science:

  • Pediatric Emergency Medicine
  • Hematology
  • Pain Management

Background:

  • Sickle cell pain crisis is a common reason for pediatric emergency department visits.
  • Delays in pain management can negatively impact patient outcomes.
  • Understanding factors contributing to delays is crucial for improving care.

Purpose of the Study:

  • To identify factors associated with delayed treatment for sickle cell pain crisis in pediatric emergency departments.
  • To determine if earlier pain management correlates with better clinical outcomes.

Main Methods:

  • Retrospective study of 160 sickle cell pain crisis visits in patients aged 21 years or younger.
  • Data extracted from electronic records included demographics, clinical characteristics, and timestamps for care milestones.
  • Analysis focused on time to initial analgesic administration and pain reassessment.

Main Results:

  • Mean time to initial analgesic administration was 89 minutes; to pain reassessment was 60 minutes.
  • Imaging orders and higher triage pain scores were associated with delays and faster treatment, respectively.
  • Earlier pain management reduced emergency department length of stay but not total hospitalization duration.

Conclusions:

  • Significant delays in initial analgesic administration for pediatric sickle cell pain crises were observed.
  • A standardized pain management approach could enhance emergency department care for sickle cell crises.
Abstract

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