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Association Between Child Life and Opioid Administration in Pediatric Trauma Patients
Aliya G Burns1, Robin K Mottern2, Alexander G Sarant3
1Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA.
Insights
Faster child life specialist (CLS) visits for pediatric trauma patients correlate with reduced opioid use. Early CLS intervention (within 6 hours) is linked to significantly lower opioid administration, improving patient care outcomes.
Area of Science:
- Pediatric trauma care
- Pain management in children
- Child life services
Background:
- Child life specialists (CLSs) support pediatric patients through medical challenges.
- The impact of timely CLS intervention on pain management, specifically opioid use, requires further investigation.
Purpose of the Study:
- To investigate the correlation between the time to CLS visit and opioid administration in pediatric trauma patients.
- To determine if early CLS intervention is associated with reduced opioid requirements.
Main Methods:
- Retrospective study of 803 pediatric trauma patients (October 2020-October 2022).
- Patients categorized into: no CLS, CLS within 6 hours (CLS <6h), and CLS >6 hours (CLS >6h).
- Statistical analysis including descriptive statistics, linear, and multivariate regression to assess opioid use.
Main Results:
- Patients receiving CLS were younger (median 7 vs 11 years) and more often female (39% vs 31%).
- Each minute delay in CLS visit correlated with a 0.015 mg increase in total opioids.
- CLS <6h group showed significantly lower total opioid and MEQ/kg opioid use compared to CLS >6h.
Conclusions:
- Increased time to CLS intervention is associated with higher total opioid administration in pediatric trauma patients.
- Early CLS intervention (within 6 hours) is linked to reduced opioid consumption, suggesting a beneficial role in pain management.
Abstract:
Introduction: Child life specialists (CLSs) are professionals who help pediatric patients navigate illness and treatment. This study hypothesizes there is a correlation between the time it takes for a pediatric trauma patient to receive a visit from CLS and the opioids administered to the patient. Methods: This retrospective study conducted between October 2020 and October 2022 included 803 patients <18. Patients were divided into three groups: patients who did not receive CLS, patients who received CLS within 6 h (CLS <6 h), and patients who received CLS more than 6 h after admission (CLS >6 h). Descriptive statistics were used to observe differences in the medians of age, total opioids (mg), MEQ/kg, MEQ/kg/length of stay, and injury severity scores between the groups. Linear regression and multivariate linear regression were run to determine the effect of time to CLS and the presence of CLS on total opioids. Results: The median age of patients who received CLS was 7 and those who did not was 11 (P < .001). Thirty-nine percent of females received CLS vs only 31% of males (P = .031). Time to being seen by CLS showed total opioids increased by 0.015 mg per minute. There were significant associations with younger age (P < .001), lower total opioids (P < .001), and lower MEQ/kg of opioids (P < .001) in patients with CLS <6 h compared to those with CLS >6 h. Conclusion: Increased time to being seen by CLS led to an increase in total opioid administration. Patients with CLS <6 h received fewer total opioids compared to those with CLS >6 h.
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