Epidemiology of paediatric pain-related visits to emergency departments in the USA: a cross-sectional study

Anderson, Jana L.; Silva, Lucas Oliveira J. e; Funni, Shealeigh A.; Bellolio, M. Fernanda; Jeffery, Molly Moore

doi:10.1136/bmjopen-2020-046497

Cited by 5 publications

(3 citation statements)

References 16 publications

(25 reference statements)

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“…[8,9] While most pharmacological therapies studied are superior to placebo, [8] many patients report dissatisfaction with traditional treatment options and concerns related to efficacy and safety [10]. Increasingly, patients across the age spectrum are seeking alternative, more "natural," nonpharmacological options, with the medical community responding with increased interest in the potential benefits of food or food extracts on functional gastrointestinal disorders [11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Kiwifruit and Kiwifruit Extracts for Treatment of Constipation: A Systematic Review and Meta-Analysis

Eltorki

Leong

Ratcliffe

2022

Canadian Journal of Gastroenterology and Hepatology

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Introduction. This systematic review aimed to summarize evidence to determine the effectiveness of kiwifruit or kiwifruit extracts in the treatment of constipation. Methods. Electronic databases were searched from inception to May 2022 without any age or language limitations. Eligible studies enrolled participants with constipation who were randomized to receive kiwifruit or kiwifruit extracts vs. any nonkiwifruit control. Standardized mean difference (SMD) and mean difference (MD) with confidence intervals (CI) were determined for the following outcomes: frequency of spontaneous bowel movements (SBM), abdominal pain and straining, as well as stool type as determined by the Bristol Stool Scale (BSS). The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach was used to rate the certainty of evidence. Our review was registered on PROSPERO (CRD42021239397). Results. Seven RCTs, including 399 participants (82% female; mean age: 42 years (SD 14.6)), were included. Compared with placebo (n = 95), kiwifruit extracts might increase the weekly frequency of SBM (MD: 1.36; 95% CI: −0.44, 3.16) with low certainty of evidence; moreover, it had an uncertain effect on BSS (SMD: 1.54; 95% CI: −1.33, 4.41) with very low certainty of evidence. Additionally, compared with placebo (n = 119), kiwifruit or its extracts reduced abdominal pain (SMD: −1.44, 95% CI −2.83, −1.66) with moderate certainty of the evidence and improved frequency of straining (SMD: −0.29; 95% CI: −1.03, 0.47). Compared with psyllium, kiwifruit may increase the weekly frequency of SBM (MD: 1.01; 95% CI: −0.02, 2.04) with moderate certainty evidence, and may increase the value on the BSS (indicating softer stools) (MD: 0.63; 95% CI: 0.01, 1.25)with low certainty of evidence. Compared to placebo, kiwifruit-encapsulated extracts may result in an increase in minor adverse events (relative risk: 4.58; 95% CI: 0.79, 26.4). Conclusions. Among individuals with constipation, there is an overall low certainty of evidence indicating that kiwifruit may increase SBM when compared to placebo or psyllium. Although overall results are promising, establishing the role of kiwifruit in constipation requires large, methodologically rigorous trials. Protocol Registration: PROSPERO registration number CRD42021239397.

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Section: Introductionmentioning

confidence: 99%

Kiwifruit and Kiwifruit Extracts for Treatment of Constipation: A Systematic Review and Meta-Analysis

Eltorki

Leong

Ratcliffe

2022

Canadian Journal of Gastroenterology and Hepatology

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“…Approximately 57% of children have pain on arrival to the emergency department (ED). 1 Most children are discharged home with moderate or severe pain and require pain treatment. [2][3][4][5] Injuries (eg, fractures, sprains, strains, contusions) are the most common cause of ED visits by children in pain.…”

Section: Introductionmentioning

confidence: 99%

Video Education Intervention in the Emergency Department

Jacobson

Coleman

Weisman

et al. 2022

WestJEM

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Introduction: After discharge from the emergency department (ED), pain management challenges parents, who have been shown to undertreat their children’s pain. Our goal was to evaluate the effectiveness of a five-minute instructional video for parents on pain treatment in the home setting to address common misconceptions about home pediatric pain management. Methods: We conducted a randomized, single-blinded clinical trial of parents of children ages 1-18 years who presented with a painful condition, were evaluated, and were discharged home from a large, tertiary care pediatric ED. Parents were randomized to a pain management intervention video or an injury prevention control video. The primary outcome was the proportion of parents that gave their child pain medication at home after discharge. These data were recorded in a home pain diary and analyzed using the chi square test to determine significant difference. Parents’ knowledge about components of at-home pain treatment were tested before, immediately following, and two days after intervention. We used McNemar’s test statistic to compare incorrect pretest/correct post-test answers between intervention and control groups. Results: A total of 100 parents were enrolled: 59 parents watched the pain education video, and 41 the control video. Overall, 75% of parents completed follow-up, providing information about home medication use. Significantly more parents provided pain medication to their children after watching the educational video: 96% vs 80% (difference 16%; 95% CI 7.8-31.3%). Significantly more parents had correct pain treatment knowledge immediately following the educational video about pain scores (P = 0.04); the positive effects of analgesics (P <0.01); and pain medication misconceptions (P = 0.02). Most differences in knowledge remained two days after the video intervention. Conclusion: The five-minute educational video about home pain treatment viewed by parents in the ED prior to discharge significantly increased the proportion of children receiving pain medication at home as well as parents’ knowledge about at-home pain management.

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“…N eedle-related procedures such as intravenous (IV) cannulations and venepunctures can be a source of varying levels of pain and anxiety for children attending emergency departments (EDs). 1 Inadequate recognition and management of procedural pain in children is known to have a detrimental impact on neurological development and could also potentially result in higher pain sensitization, increased incidence of chronic pain, delayed wound healing, and health care avoidance behavior. 2 In addition, long-term psychological sequelae in the form of significant preprocedural anxiety during adulthood can also be caused by suboptimal pain management during childhood.…”

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confidence: 99%

Efficacy of Buzzy Device Versus EMLA Cream for Reducing Pain During Needle-Related Procedures in Children

Haidar,

Al Amri,

Sendad

et al. 2023

Pediatr Emer Care

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Objectives: Several pain management tools exist but with limitations in their efficacy or applicability. The EMLA (eutectic mixture of local anesthetics) cream is currently used for pain relief for needle-related procedures; however, it needs a minimum of 30 to 45 minutes to be effective. The Buzzy is a device that generates vibrations with cold leading to quicker pain relief. Our aim was to evaluate the effect of the Buzzy device in pain and anxiety reduction compared with EMLA cream in children requiring intravenous cannulation or venepuncture.Methods: This was a randomized clinical trial comparing pain and anxiety reduction by Buzzy device with the standard care (EMLA cream) in children aged 2 to 14 years who required blood extraction or intravenous cannulation based on their clinical needs. Eligible patients were randomized to either Buzzy device as the intervention or EMLA cream as the control. The outcome measures were the degree of pain scores and anxiety ratings at different stages of the needle-related procedures.Results: A total of 300 patients with a mean age of 6.5 ± 3.1 years were enrolled. Baseline characteristics were similar between the Buzzy device and EMLA cream groups. The observed pain scores by research nurses and a parent were significantly lower in the EMLA group compared with the Buzzy device group; however, the pain scores by the self-assessment scale were not statistically significant with mean difference of −0.332, 95% confidence interval, −0.635 to −0.028 ( P = 0.062). The level of anxiety was significantly lower in EMLA compared with Buzzy device ( P = 0. 0.0001). Both staff and parents' satisfaction, success rate of cannulation, type of blood tests, and comment on the physician on the results were similar in both groups.Conclusions: Pain and anxiety relief using the Buzzy device is not as effective as EMLA cream in children requiring venepuncture. However, rapid onset of action of the Buzzy device is valuable in decreasing waiting time in a busy emergency department.

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Epidemiology of paediatric pain-related visits to emergency departments in the USA: a cross-sectional study

Cited by 5 publications

References 16 publications

Kiwifruit and Kiwifruit Extracts for Treatment of Constipation: A Systematic Review and Meta-Analysis

Kiwifruit and Kiwifruit Extracts for Treatment of Constipation: A Systematic Review and Meta-Analysis

Video Education Intervention in the Emergency Department

Efficacy of Buzzy Device Versus EMLA Cream for Reducing Pain During Needle-Related Procedures in Children

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