Pain Management of Musculoskeletal Injuries in Children: Current State and Future Directions

@article{Ali2010PainMO,
  title={Pain Management of Musculoskeletal Injuries in Children: Current State and Future Directions},
  author={Samina Ali and Amy L Drendel and Janeva Kircher and Suzanne M. Beno},
  journal={Pediatric Emergency Care},
  year={2010},
  volume={26},
  pages={518-524}
}
Background: Pain is the most common reason for seeking health care in the Western world and is a contributing factor in up to 80% of all emergency department (ED) visits. In the pediatric emergency setting, musculoskeletal injuries are one of the most common painful presentations. Inadequate pain management during medical care, especially among very young children, can have numerous detrimental effects. No standard of care exists for the management of acute musculoskeletal injury-related pain… Expand
Approaches to Pediatric Musculoskeletal Pain: Opioids and So Much More.
TLDR
Strategies for collaborating with families and the multidisciplinary team, an overview of pediatric pain assessment including assessment of acute musculoskeletal pain in children, and pharmacological and nonpharmacological options for managing pain after acute injury or surgery are reviewed. Expand
Pediatric musculoskeletal pain in the emergency department: a medical record review of practice variation.
OBJECTIVE Musculoskeletal (MSK) injuries are a common, painful pediatric presentation to the emergency department (ED). The primary objective of this study was to describe current analgesicExpand
Acute Pediatric Musculoskeletal Pain Management in North America
TLDR
Choice of analgesic agents is heterogeneous among physicians and is influenced by pain severity, child’s age, and physician characteristics. Expand
Efficacy of ibuprofen in musculoskeletal post-traumatic pain in children: A systematic review
TLDR
There’s no straightforward statistically significant evidence of the optimal analgesic agent to be used, however, ibuprofen may be preferable as the initial drug of choice in providing relief from MSK pain due to the favorable combination of effectiveness and safety profile. Expand
Acute pain management in children: a survey of Italian pediatricians
TLDR
Several gaps exist between the current practice of pain assessment and treatment and recommendations and further efforts are needed to raise awareness and improve education on the possible exposure of the child to short- and long-term consequences in case of suboptimal pain management. Expand
Canadian Emergency Medicine Residents' Perspectives on Pediatric Pain Management.
TLDR
Canadian EM residents report receiving inadequate training in pediatric pain management, and are particularly uneasy with younger or developmentally disabled children, post-graduate curricula should be adjusted to correct these self-identified weaknesses in children's pain management. Expand
Treating and Reducing Anxiety and Pain in the Paediatric Emergency Department: The TRAPPED survey.
TLDR
There was wide variation in paediatric pain and anxiety management strategies among tertiary care Canadian emergency departments and several pain-reduction procedures were identified that could be easily implemented to address the gap. Expand
Oral Analgesics Utilization for Children With Musculoskeletal Injury (OUCH Trial): An RCT
TLDR
Combination of morphine with ibuprofen did not provide adequate pain relief for children with MSK-I in the ED and none of the study medication provided an optimal pain management because most of children did not reach a mild pain score. Expand
A survey of children's perspectives on pain management in the emergency department.
TLDR
Despite continued pain upon discharge, most children were satisfied with their pain management, however, it is important that emergency physicians not interpret patient satisfaction as equivalent to adequate provision of analgesia. Expand
Ethnicity and Reported Pain Scores Among Children With Long-Bone Fractures Requiring Emergency Care
TLDR
This is the first study to investigate the relationships between ethnicity and pain scores reported in children treated emergently for a long-bone fracture and found patients identified as Hmong had the highest pain scores, and patients identified with Somali had the lowest pain scores. Expand
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 82 REFERENCES
Pain Management Practices in a Pediatric Emergency Room (PAMPER) Study: Interventions With Nurses
TLDR
The interventions contributed to the improvement of the nurses' knowledge of pain management and some of the practices over time and it is believed that an intervention tailored to nurses' needs and schedule has more impact than just passive diffusion of educational content. Expand
Pediatric emergency department analgesic practice
TLDR
These data from 1994 document suboptimal analgesic use and home analgesic instruction for children in a pediatric emergency department with burns and fractures. Expand
Pain in the emergency department: results of the pain and emergency medicine initiative (PEMI) multicenter study.
TLDR
It is concluded that ED pain intensity is high, analgesics are underutilized, and delays to treatment are common, and there is much room for improvement in this area. Expand
Pain management in the emergency department: patterns of analgesic utilization.
TLDR
ED analgesia continues to be used less frequently in the pediatric compared with the adult population, and inadequate dosing of discharge analgesic medication in children is a significant problem. Expand
Practice Patterns of Pediatric Versus General Emergency Physicians for Pain Management of Fractures in Pediatric Patients
TLDR
Most children with an extremity fracture and greater than one-third of children with a severe fracture did not receive pain medications in the emergency department, and both PEM physicians and GEM physicians have similar practices of analgesic administration for fracture reduction, with a notable exception in the types of agents used during procedural sedation. Expand
Emergency department analgesic use in pediatric trauma victims with fractures.
TLDR
It is suggested that ED analgesic use was low in these mildly to moderately injured children with presumably painful fractures who are also at risk for associated multiple injuries. Expand
Outpatient Pediatric Pain Management Practices for Fractures
TLDR
Most children with fractures have the "worst" pain in the first 48 hours after injury and used analgesia for 3 days after injury, with no clear superiority. Expand
Emergency department management of pain and anxiety related to orthopedic fracture care: a guide to analgesic techniques and procedural sedation in children.
TLDR
No single regimen is likely to provide the best means of analgesia and anxiolysis for all patients, and strategies for the management of fracture pain may vary by fracture location and patient characteristics. Expand
Emergency department analgesia for fracture pain.
TLDR
In pediatric and adult patients, pain medications were frequently not part of ED treatment for fractures, even for visits with documented moderate or severe pain, and children treated in pediatric EDs were about as likely to receive any analgesia. Expand
Complementary and alternative medicine for acute procedural pain in children.
TLDR
Despite the promise of many of these modalities, it is concluded that further empirical research into safety and efficacy using well-designed studies and large samples is required before guidelines can be established. Expand
...
1
2
3
4
5
...