Emergency Department Pain Management in Pediatric Patients With Fracture or Dislocation in a Bi-Ethnic Population

Annals of Emergency Medicine
Itai ShavitCarmit Steinberg

Abstract

We determine whether ethnicity in a bi-ethnic population of northern Israel is associated with disparities in pediatric emergency department (ED) opioid analgesia in patients with fracture or dislocation. A retrospective cohort study was conducted. All records of patients aged 3 to 15 years and receiving a diagnosis of a limb fracture or dislocation were extracted. Data on demographics, including ethnicity, nurse ethnicity, pain level, and pain medication, were collected. Medications were administered according to a nurse-driven pain protocol. During the nearly 4-year study period, 3,782 children with fractures visited the ED, 1,245 Arabs and 2,537 Jews. Of these, 315 Arabic patients and 543 Jewish patients had a pain score of 7 to 10. The proportion of Arabic and Jewish children who received opioid therapy was 312 of 315 (99.05%) and 538 of 543 (99.08%), respectively (difference 0.03%; 95% confidence interval -0.13% to 0.19%). Of the 315 Arabic children, 99 were approached by Arabic nurses (31.4%), and 98 of those received opioids (98.9%); 216 were approached by Jewish nurses (68.6%), and 214 of those received opioids (99%). Of the 543 Jewish children, 351 were approached by Jewish nurses (64.6%), and 348 of those received opi...Continue Reading

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Citations

Apr 1, 2017·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Raviv AllonItai Shavit
Feb 9, 2017·The Clinical Journal of Pain·Ron JacobItai Shavit
Feb 7, 2020·The Clinical Journal of Pain·Itai ShavitOren Feldman

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