Acute pediatric musculoskeletal pain management in North America: a practice variation survey. Clin Pediatr (Phila) 2014 Dec;53(14):1326-35
Date
11/09/2014Pubmed ID
25381329DOI
10.1177/0009922814555972Scopus ID
2-s2.0-84911499993 (requires institutional sign-in at Scopus site) 25 CitationsAbstract
Children's musculoskeletal (MSK) injury pain remains poorly managed. This survey of pediatric emergency physicians and orthopedic surgeons assessed analgesia administration practices and discharge advice for children with acute MSK pain; 683 responses were received. Ibuprofen was the most commonly reported analgesic used in the emergency department (52%) and at discharge (68%). Most (85%) reported using oral opioids in the previous 6 months. Codeine use was the most commonly reported opioid used in the emergency department (38%) and at home (51%). For equal levels of pain, younger children received less opioids than older children. Younger physicians and recent graduates chose acetaminophen and codeine more than older and more experienced colleagues, who preferred ibuprofen and non-codeine containing opioid compounds (P < .001 and .006, respectively). Orthopedic surgeons reported less ibuprofen use than pediatric emergency physicians (P < .001). Choice of analgesic agents is heterogeneous among physicians and is influenced by pain severity, child's age, and physician characteristics.
Author List
Kircher J, Drendel AL, Newton AS, Plint AC, Vandermeer B, Dulai S, Ali SAuthor
Amy L. Drendel DO Interim Chief, Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Acute PainAdolescent
Adult
Analgesics
Canada
Child
Child, Preschool
Cross-Sectional Studies
Emergency Service, Hospital
Female
Health Care Surveys
Humans
Infant
Male
Middle Aged
Musculoskeletal Pain
Pain Measurement
Patient Discharge
Practice Patterns, Physicians'
Self Care
United States
