Variation in Acute Pain Management of Youth With Nonfatal Firearm Injuries

Area of Science:

• Pediatric Emergency Medicine
• Trauma Surgery
• Public Health

Background:

• Firearm injuries represent a significant cause of morbidity in pediatric populations.
• Current practices for acute pain management following nonfatal firearm injuries are not well-documented.
• Understanding pain medication administration is crucial for improving care outcomes.

Purpose of the Study:

• To evaluate the administration of acute pain medications in youth with nonfatal firearm injuries.
• To identify sociodemographic characteristics and injury severity associated with pain management.
• To assess variations in analgesic use, including opioids and nonopioids.

Main Methods:

• Retrospective cross-sectional analysis of the Pediatric Health Information System (2016-2021).
• Inclusion of inpatient and emergency department (ED) encounters for firearm injuries in patients aged 0-21 years.
• Multivariable logistic regression to analyze associations between patient characteristics and analgesic administration (none, nonopioid only, opioid).

Main Results:

• Analysis included 4924 patients with nonfatal firearm injuries.
• 39.0% of ED-discharged patients received no analgesia versus 3.5% of admitted patients.
• Younger children, Non-Hispanic White, and Hispanic patients were more likely to receive no analgesia compared to Non-Hispanic Black patients.
• Opioid receipt was lower in younger children (5-9 years), females, and Hispanic/Non-Hispanic White patients.

Conclusions:

• Significant variations in analgesia administration were observed, particularly in the emergency department-discharged population.
• Findings suggest potential undertreatment of pain and disparities in acute pain management for youth with nonfatal firearm injuries.
• Further research is needed to address these differences and optimize pain management strategies.