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Impact of Prehospital Pain Management on Emergency Department Management of Injured Children

M I Harris1, K M Adelgais2, S W Linakis3

  • 1Department of Pediatrics, Northwell Hofstra School of Medicine, New Hyde Park, New York.

Prehospital Emergency Care
|November 4, 2021
PubMed

Insights

Prehospital opioid administration significantly reduces pain in injured children arriving at the emergency department (ED). This intervention also leads to earlier and higher doses of opioid analgesia during ED care.

Area of Science:

  • Pediatric Emergency Medicine
  • Pain Management
  • Emergency Medical Services (EMS)

Background:

  • Providing pain relief for injured children in prehospital settings is a significant challenge for Emergency Medical Services (EMS) clinicians.
  • The impact of prehospital pain management on subsequent emergency department (ED) care is not well understood.

Purpose of the Study:

  • To investigate the effect of prehospital pain interventions on initial pain scores in the ED.
  • To analyze the timing and dosage of analgesia administered in the ED for injured children transported by EMS.

Main Methods:

  • Secondary analysis of a prospective multicenter cohort study involving children with injuries.
  • Comparison of pain score changes and ED analgesia administration between children who received prehospital interventions and those who did not.
  • Statistical analysis using Wilcoxon rank sum and chi-square tests.

Main Results:

  • Of 474 children, 55% received prehospital interventions, with 19% receiving prehospital opioids.
  • Children receiving prehospital opioids showed a greater reduction in pain severity.
  • Prehospital opioid use was associated with earlier and higher doses of ED opioid administration.

Conclusions:

  • Prehospital opioid analgesia significantly reduces pain severity upon ED arrival.
  • Prehospital opioid administration is linked to earlier and more aggressive opioid treatment during ED care.
Abstract

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