Does age affect analgesia provision at discharge among children with long bone fractures requiring emergency care?

Abstract

BACKGROUND:

Inadequate treatment of painful conditions in children is a significant and complex problem. The wide range of cognitive abilities associated with a child's age is a particular challenge for providers treating children with painful conditions.

STUDY OBJECTIVE:

To examine the effect of patient age on the provision of analgesic medicines at discharge in children treated emergently for a long bone fracture.

METHODS:

A retrospective review was performed of all patients during a 1-year period with a long bone fracture treated in two urban pediatric Emergency Departments (EDs).

RESULTS:

Eight hundred seventy-eight patients were identified who met our inclusion criteria. Nearly 60% of patients received a prescription for an opioid-containing medicine and 19% received a prescription for an over-the-counter analgesic medicine at ED discharge. Patients younger than 4 years old had lower pain scores, less severe fractures, and overall were significantly less likely to receive an opioid-containing prescription compared to children 4 years old or greater. In children with more severe fractures requiring reduction in the ED, no significant age-related differences were noted in opioid prescription rates. No age-related significant differences were noted for over-the-counter prescription analgesic medicines provided at discharge.

CONCLUSION:

Young patient age is associated with different analgesic prescription patterns in children treated in the ED for a long bone fracture.

• Authors: Henry W Ortega, Heidi Vander Velden, Chia-Wei Lin, James A Engels, Samuel Reid
• Journal: The Journal of emergency medicine (J Emerg Med) Vol. 45 Issue 5 Pg. 649-57 (Nov 2013) ISSN: 0736-4679 [Print] United States
• PMID: 23845523 (Publication Type: Journal Article)
• Copyright: Copyright © 2013 Elsevier Inc. All rights reserved.

Chemical References

• Analgesics, Opioid
• Nonprescription Drugs

Topics

• Adolescent
• Adult
• Age Factors
• Analgesics, Opioid (therapeutic use)
• Child
• Child, Preschool
• Emergency Service, Hospital
• Female
• Fractures, Bone (complications, therapy)
• Humans
• Male
• Nonprescription Drugs (therapeutic use)
• Pain (drug therapy, etiology)
• Pain Measurement
• Patient Discharge
• Retrospective Studies
• Urban Health Services
• Young Adult