Impact of Prehospital Pain Management on Emergency Department Management of Injured Children

被引:6
作者
Harris, M. I. [1 ]
Adelgais, K. M. [2 ]
Linakis, S. W. [3 ,4 ]
Magill, C. F. [5 ]
Brazauskas, R. [6 ]
Shah, M. I. [7 ]
Nishijima, D. K. [8 ]
Lowe, G. S. [9 ]
Chadha, K. [10 ]
Chang, T. P. [11 ,12 ]
Lerner, E. B. [10 ]
Leonard, J. C. [3 ,4 ]
Schwartz, H. P. [13 ]
Gaither, J. B. [14 ]
Studnek, J. R. [15 ]
Browne, L. R. [16 ,17 ]
机构
[1] Northwell Hofstra Sch Med, Dept Pediat, New Hyde Pk, NY 11549 USA
[2] Univ Colorado, Dept Pediat, Aurora, CO USA
[3] Nationwide Childrens Hosp, Dept Pediat, Columbus, OH USA
[4] Ohio State Univ, Columbus, OH 43210 USA
[5] Atrium Healths Carolinas Med Ctr, Dept Emergency Med, Charlotte, NC USA
[6] Med Coll Wisconsin, Dept Inst Hlth Equ, Milwaukee, WI 53226 USA
[7] Baylor Coll Med, Dept Pediat, Sect Emergency Med, Houston, TX USA
[8] Univ Calif Davis, Dept Emergency Med, Sacramento, CA USA
[9] Univ Texas Southwestern, Dept Pediat, Dallas, TX USA
[10] SUNY Buffalo, Dept Emergency Med, Buffalo, NY USA
[11] Univ Southern Calif, Childrens Hosp Angeles, Dept Pediat, Los Angeles, CA USA
[12] Univ Southern Calif, Keck Sch Med, Dept Pediat, Los Angeles, CA USA
[13] Univ Cincinnati, Coll Med, Dept Pediat, Div Emergency Med, Cincinnati, OH USA
[14] Univ Arizona, Dept Emergency Med, Tucson, AZ USA
[15] Mecklenburg EMS Agcy, Charlotte, NC USA
[16] Med Coll Wisconsin, Dept Pediat, 8701 Watertown Plank Rd, Milwaukee, WI 53226 USA
[17] Med Coll Wisconsin, Dept Emergency Med, Milwaukee, WI 53226 USA
关键词
ANALGESIA; BARRIERS;
D O I
10.1080/10903127.2021.2000683
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
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.
引用
收藏
页码:1 / 9
页数:9
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