Faculty Collaboration Database

Impact of Prehospital Pain Management on Emergency Department Management of Injured Children. Prehosp Emerg Care 2023;27(1):1-9

Date

11/05/2021

Pubmed ID

34734787

DOI

10.1080/10903127.2021.2000683

Scopus ID

2-s2.0-85121815799 (requires institutional sign-in at Scopus site)   4 Citations

Abstract

OBJECTIVE: Provision of analgesia for injured children is challenging for Emergency Medical Services (EMS) clinicians. Little is known about the effect of prehospital analgesia on emergency department (ED) care. We aimed to determine the impact of prehospital pain interventions on initial ED pain scale scores, timing and dosing of ED analgesia for injured patients transported by EMS.

METHODS: This is a planned, secondary analysis of a prospective multicenter cohort of children with actual or suspected injuries transported to one of 11 PECARN-affiliated EDs from July 2019-April 2020. Using Wilcoxon rank sum for continuous variables and chi-square testing for categorical variables, we compared the change in EMS-to-ED pain scores and timing and dosing of ED-administered opioid analgesia in those who did and those who did not receive prehospital pain interventions.

RESULTS: We enrolled 474 children with complete prehospital and ED pain management data. Prehospital interventions were performed on 262/474 (55%) of injured children and a total of 88 patients (19%) received prehospital opioids. Children who received prehospital opioids with or without adjunctive non-pharmacologic pain management experienced a greater reduction in pain severity and were more likely to receive ED opioids in higher doses earlier and throughout their ED care. Non-pharmacologic pain interventions alone did not impact ED care.

CONCLUSIONS: We demonstrate that prehospital opioid analgesia is associated with both a significant reduction in pain severity at ED arrival and the administration of higher doses of opioid analgesia earlier and throughout ED care.

Author List

Harris MI, Adelgais KM, Linakis SW, Magill CF, Brazauskas R, Shah MI, Nishijima DK, Lowe GS, Chadha K, Chang TP, Lerner EB, Leonard JC, Schwartz HP, Gaither JB, Studnek JR, Browne LR

Author

Ruta Brazauskas PhD Associate Professor in the Data Science Institute department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Analgesics
Analgesics, Opioid
Child
Emergency Medical Services
Emergency Service, Hospital
Humans
Pain
Pain Management
Prospective Studies
Retrospective Studies