Addressing Racial and Ethnic Inequities in Pediatric Pain Management in Emergent Settings

Area of Science:

• Pediatric Emergency Medicine
• Health Equity
• Pain Management

Background:

• Pain is a primary reason children access emergency medical services (EMS) and emergency departments (EDs).
• Despite existing pediatric pain management guidelines, persistent racial and ethnic inequities exist.
• These disparities contribute to undertreatment and oligoanalgesia in minoritized pediatric populations.

Purpose of the Study:

• To review current literature on racial and ethnic inequities in pediatric pain management within emergent care.
• To identify actionable strategies and research priorities for advancing equitable pain care.
• To synthesize findings on disparities across the continuum of emergent care settings.

Main Methods:

• Systematic literature review of studies on racial and ethnic disparities in pediatric pain management.
• Analysis of data concerning analgesia administration and pain relief in emergent settings.
• Synthesis of evidence on prehospital and emergency department pain care.

Main Results:

• Children from minoritized racial and ethnic groups are less likely to receive analgesia, including opioids, in prehospital settings.
• These children also experience less pain relief, a phenomenon known as oligoanalgesia.
• Evidence on disparities in discharge prescribing practices is currently mixed.

Conclusions:

• Addressing racial and ethnic inequities in pediatric pain management is crucial.
• Understanding the multifactorial drivers of these disparities is essential for progress.
• Implementing equity-centered interventions, standardizing processes, and mitigating bias are key strategies.