ED Fracture Pain Management in Children

Gourde, Jennifer; Damian, Frances J.

doi:10.1016/j.jen.2011.03.002

Cited by 6 publications

(5 citation statements)

References 20 publications

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“…The use of opioids for the children has been reported to be insufficient, despite the fact that these drugs play a more important role in the ED management of pain in adults . There was also a limited use of opioids in our sample population, and these drugs were reserved mostly for children with more severe pain and older children, when compared to those treated with nonopioid drugs, as previously reported by various authors .…”

Section: Discussionsupporting

confidence: 65%

Multicentre emergency department study found that paracetamol and ibuprofen were inappropriately used in 83% and 63% of paediatric cases

Benini¹,

Castagno

Barbi

et al. 2018

Acta Paediatrica

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Section: Discussionsupporting

confidence: 65%

Multicentre emergency department study found that paracetamol and ibuprofen were inappropriately used in 83% and 63% of paediatric cases

Benini¹,

Castagno

Barbi

et al. 2018

Acta Paediatrica

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“…Fractures are an ideal injury to study because they typically present with significant pain and are accurately and easily diagnosed using imaging [10][11][12][13]. For these reasons it is unlikely fractures will be underreported relative to other injuries.…”

Section: Introductionmentioning

confidence: 99%

“…Similar to prior work, this study aims to identify how trends, rates, and mechanisms of pediatric fractures were altered by the coronavirus pandemic and associated SAH/shelter-in-place (SIP) orders at a single, level I pediatric trauma center in the Western USA. Fractures are an ideal injury to study because they typically present with significant pain and are accurately and easily diagnosed using imaging [10–13]. For these reasons it is unlikely fractures will be underreported relative to other injuries.…”

Section: Introductionmentioning

confidence: 99%

Multi-day delay to care identified in pediatric trauma cases during COVID-19

Shaw

Salton

Carry

et al. 2021

Journal of Pediatric Orthopaedics B

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This study aims to establish how pediatric fracture patterns were altered at a level 1 trauma center in a state that implemented a shutdown during the initial height of COVID-19. After IRB approval, we identified 2017 patients treated at a pediatric institution for definitive management of a fracture between 26 March and 31 May 2018, 2019, or 2020. Dates were chosen based on statewide stay-at-home orders for Colorado. Patients were excluded for treatment at another institution ( n = 148), no fracture noted in clinic ( n = 18), or other ( n = 13). Data were retrospectively collected from the remaining 1838 patients regarding demographics, fracture injury, mechanism, and treatment. Odds ratios (ORs) were calculated for each variable during COVID-19 relative to prior years. The number of fractures during 2020 decreased by 26% relative to 2019 and 23% to 2018. A larger proportion of patients experienced at least a 5-day delay to definitive treatment [OR: 1.55, confidence interval (CI): 1.23–1.96, P = 0.0002]. Rates of non-accidental trauma (NAT) increased non-significantly (OR: 2.67, CI: 0.86–8.32, P = 0.0900) during 2020 (1.2%) relative to 2018 (0.6%) and 2019 (0.3%). Fractures occurring at home increased to 79.9% (OR: 6.44, CI: 5.04–8.22, P < 0.0001). Despite less overall trauma during shelter-in-place orders, greater fracture numbers were seen among younger children and severe fractures were likely among older children. Patients may hesitate to seek care during 2020. Rates of NAT doubled during 2020. As communities prepare for future waves, treatment centers should warn against common fracture mechanisms and raise awareness of NAT.

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“…It is essential that parents of children who have presented to the ED understand all discharge information provided to them, otherwise they may be unable to effectively manage their child’s care at home. For example, previous studies have reported that some parents are poor judges of their child’s pain and do not adequately understand pain management at home (Crocker et al, 2012; Gourde and Damian, 2012). Provision of written resources is advantageous because they can be accessed at home when the parent may be more relaxed and receptive to information.…”

Section: Introductionmentioning

confidence: 99%

Analysis of written resources for parents of children discharged from a paediatric emergency department

Phonpruk

Flowers

Naughton

et al. 2019

J Child Health Care

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The aim of this study was to profile the information and readability of parent-focused resources to support care at home following a child’s discharge from a paediatric emergency department (ED). Analysis included recording the scope, source, readability scores and benchmarking the contents against previous recommendations for discharge information. Information from 46 resources (on 41 conditions) from three separate sources was analysed. Overall, a wide range of resources was available. Inconsistency was evident in the framework and design of resources available. Approximately two-thirds of resources provided information about referral to community resources, and most had links to community health providers. Assessment of readability levels showed a predominant pitch towards a relatively high level of schooling. Existing written resources available for parents to use in caring for their child following discharge from an ED could improve with more streamlined designs as well as consistent references to community resources and additional health providers. Parents with low reading capacity may not be able to make the most of existing resources to care for their child at home following ED discharge. This framework was developed for reviewing the resources that could be useful for quality assessment of other parent-focused discharge information.

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ED Fracture Pain Management in Children

Cited by 6 publications

References 20 publications

Multicentre emergency department study found that paracetamol and ibuprofen were inappropriately used in 83% and 63% of paediatric cases

Multicentre emergency department study found that paracetamol and ibuprofen were inappropriately used in 83% and 63% of paediatric cases

Multi-day delay to care identified in pediatric trauma cases during COVID-19

Analysis of written resources for parents of children discharged from a paediatric emergency department

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