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An Assessment of Child Life Service and Pain Management in Pediatric Trauma Patients
Morgan Merritt1, Lora Kasselman2, Beth VanBuskirk1
1K. Hovnanian Children's Hospital at Jersey Shore University Medical Center, Neptune City.
Insights
Pediatric trauma patients receiving Child Life Services (CLS) experienced significantly lower pain scores at discharge compared to those without CLS. This highlights the positive impact of CLS on pain management in pediatric trauma care.
Area of Science:
- Pediatric Emergency Medicine
- Trauma Care
- Child Life Services
Background:
- Pain management is crucial for pediatric trauma patients.
- Child Life Services (CLS) aim to support children during healthcare experiences.
- The impact of CLS on pain outcomes in pediatric trauma is not fully understood.
Purpose of the Study:
- To investigate differences in pain outcomes for pediatric trauma patients who receive Child Life Services versus those who do not.
- To determine if CLS involvement correlates with reduced pain scores at discharge.
Main Methods:
- Retrospective chart review of pediatric trauma patients (birth to 21 years).
- Patients categorized into groups: with and without Child Life Specialist (CLS) visits.
- Pain scores assessed using validated scales (FLACC, Wong-Baker FACES, V NRS, CPOT).
- Patients matched by initial pain score and Injury Severity Score (ISS); ordinal logistic regression used.
Main Results:
- 196 patients included; 107 (54%) received CLS.
- Groups had similar demographics and ISS.
- Pain scores at discharge were significantly lower for patients with CLS (median=0) compared to those without (median=2; P=0.009).
Conclusions:
- Child Life Specialist involvement is associated with lower pain scores in pediatric trauma patients upon discharge.
- CLS appears to be an effective intervention for improving pain management in this population.
- Further research can explore specific CLS interventions and their impact on pain.
Objective:
The objective of this study is to investigate differences in pain outcomes for pediatric trauma patients who receive Child Life Services versus pediatric trauma patients who do not.
Methods:
Retrospective chart reviews were completed on patients birth to 21 years of age who were seen by trauma services in the Emergency Department and various inpatient units. These individuals were characterized into 2 groups: those seen by child life specialists and those who were not. Pain scores were recorded by using the following scales: face, legs, activity, cry, consolability (FLACC), The Wong-Baker FACES, the Verbal Numeric Rating Score, and Critical Care Pain Observation Tool (CPOT). Baseline data included age, sex, race, injury type, Injury Severity Score (ISS), pain score, and length of stay. Patients were matched using the initial pain score and ISS score. An ordinal logistic model was built regressing pain at discharge on group (CLS visit or no CLS visit). Significance was set at P ≤0.05.
Results:
One hundred ninety-six patients' data were used; 107 (54%) of them had been seen by child life specialists. The study groups had similar baseline demographics and injury severity scores. The pain score at discharge was significantly lower in children with child life services' visits (median=0, min=0, max=10) compared with those without [median=2, min=0, max=10; OR=0.48, 95% CI (0.28, 0.83), P =0.009].
Conclusions:
Certified child life specialist involvement in pediatric trauma patients' care correlates to a lower pain score upon discharge.
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