Is caregiver refusal of analgesics a barrier to pediatric emergency pain management? A cross-sectional study in two Canadian centres

CJEM
Caroline WhistonNaveen Poonai

Abstract

The suboptimal provision of analgesia to children in the emergency department (ED) is well-described. A yet unexplored barrier is caregiver or child refusal of analgesia. We sought to evaluate the frequency of caregiver/child acceptance of analgesia offered in the ED. We conducted a two-centre cross-sectional study of 743 caregivers of children 4–17 years presenting to the pediatric ED with an acutely painful condition using a survey and medical record review. The primary outcome was the proportion of children/caregiver pairs who accepted analgesia in the ED. The median (IQR) age of children was 11 (7) years, and 339/743 (45.6%) were female. The overall survey response rate was 73% (743/1018). In the 24 hours preceding ED arrival, the median (IQR) maximal pain score rated by children and caregivers was 8/10 (4) and 5/10 (2), respectively, and 30.4% (226/743) of caregivers offered analgesia. In the ED, children reported a median (IQR) pain score of 8/10 (2) and 54.9% (408/743) were offered analgesia. When offered in the ED, analgesia was accepted by 91% (373/408). Overall, 55.7% (414/743) of children received some form of analgesia. Most caregivers/children accept analgesia when offered by ED personnel, suggesting refusal is not...Continue Reading

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Citations

May 28, 2020·Dental Traumatology : Official Publication of International Association for Dental Traumatology·Peter DayLiran Levin
Dec 18, 2020·The Journal of Pediatrics·Samina AliUNKNOWN Alberta Provincial Pediatric EnTeric Infection TEam (APPETITE Team) and Pediatric Emergency Research Canada (PERC)
Dec 30, 2019·Paediatrics & Child Health·Esther JunUNKNOWN Pediatric Emergency Research Canada

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