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Protocolized Pain Assessment and Management in Pediatric Trauma Patients

Oluwaseun Adeyemi1, Shareef Syed1, Vrindda Atrii1

  • 1Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.

The Journal of Surgical Research
|July 7, 2026
PubMed

Insights

A new pain assessment and treatment (PAT) protocol increased pain assessment in pediatric trauma patients. However, pain evaluation needs improvement for young children and trauma activation cases.

Area of Science:

  • Pediatric Emergency Medicine
  • Trauma Care
  • Pain Management

Background:

  • Inadequate pain assessment is a significant issue in pediatric trauma care.
  • A standardized Pain Assessment and Treatment (PAT) protocol was introduced to improve pain evaluation consistency.
  • This study investigated the adoption rate and adherence factors of the PAT protocol.

Purpose of the Study:

  • To evaluate the impact of a Pain Assessment and Treatment (PAT) protocol on pain assessment frequency in pediatric trauma patients.
  • To identify factors influencing the adoption and adherence to the PAT protocol.

Main Methods:

  • A cross-sectional study analyzed data from 908 pediatric trauma patients (ages 0-14) treated between 2021 and 2025.
  • Pain assessment was the primary outcome, with sociodemographic, injury, and system-level factors as predictors.
  • Logistic regression models were used to determine factors associated with PAT protocol adoption and adherence.

Main Results:

  • Pain assessment occurred in 79% of pediatric trauma patients following PAT protocol implementation.
  • Protocol adherence increased from 62% in 2021 to 85% in 2023, then plateaued.
  • Pre-teens (vs. infants/toddlers) were more likely to have pain assessed (aOR: 1.73), while trauma activations were less likely (aOR: 0.38).

Conclusions:

  • The PAT protocol significantly increased pain assessment rates in pediatric trauma patients.
  • Further improvements are needed to ensure consistent pain assessment for the youngest pediatric trauma patients (0-3 years).
  • Optimizing pain assessment for pediatric trauma patients presenting as trauma activations requires targeted strategies.
Abstract

Keywords:
PainPain assessment and treatmentPain protocolPediatric traumaTrauma resuscitation

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