Oral morphine protocol evaluation for the treatment of vaso-occlusive crisis in paediatric sickle cell patients

Paediatrics & Child Health
Hugo PaquinBenoit Bailey

Abstract

Vaso-occlusive crisis (VOC) is one of the most frequent causes of emergency visit and admission in children with sickle cell disease (SCD). This study aimed to evaluate whether the implementation of a protocol promoting the use of oral morphine as a primary intervention has led to improved care of SCD. We performed a retrospective chart review of patients with SCD who presented to the emergency department (ED) and hematology outpatient clinic (HOC) with VOC, in the year pre and postimplementation of the protocol. The primary outcome was the hospitalization rate. The protocol resulted in a significant 43% reduction of hospitalization rate (95% confidence interval [CI] -53.0, 26.5). Results also showed a 35% increase in the use of oral morphine as first-line opiate treatment (95% CI 17.9, 45.2), a 28% increase in the use of pain scales (95% CI 17.3, 43.2) and a 30% net increase in patients eventually not requiring intravenous (IV) line placement (95% CI 16.0, 39.9). While we did observe an overall decrease in length of stay in ED of -55 min (95% CI -100.6, -12.0), there was a nonsignificant decrease of 7 minutes (95% CI -26, 3) in the opiate administration time. This study validates the use of our oral morphine protocol for the t...Continue Reading

References

Nov 1, 1990·Trends in Neurosciences·M Fitzgerald
Jun 9, 1994·The New England Journal of Medicine·O S PlattP P Klug
Apr 29, 2005·Journal of Pain and Symptom Management·Eufemia JacobLori Styles
Sep 1, 2005·Health and Quality of Life Outcomes·Donna K McClishWally R Smith
Apr 4, 2007·The Journal of Clinical Investigation·Paul S Frenette, George F Atweh
Nov 26, 2008·Paediatrics & Child Health·Nancy RobitailleHeather A Hume
Mar 3, 2010·Blood·Charles T QuinnGeorge R Buchanan
May 5, 2010·Current Opinion in Supportive and Palliative Care·Josh Wright, Sam H Ahmedzai
Feb 7, 2012·Annals of Emergency Medicine·Jocelyn GravelDevendra Amre
May 3, 2013·Pediatric Blood & Cancer·Dima Hamideh, Ofelia Alvarez
Jun 26, 2014·Pediatric Blood & Cancer·Lakshmanan KrishnamurtiRichard Saladino
Feb 3, 2016·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Richard WardMadeleine Verhovsek
May 7, 2016·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Nadia S Ruta, Samir K Ballas

❮ Previous
Next ❯

Citations

Dec 3, 2020·Early Human Development·Rosana M TristãoElisabeth Fournier-Charrière
Feb 7, 2020·The Clinical Journal of Pain·Itai ShavitOren Feldman
Apr 9, 2021·Peptides·Richard J Bodnar
Aug 24, 2021·The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG·Claire ArbitreEvelyne D Trottier

❮ Previous
Next ❯

Related Concepts

Related Feeds

Anemia

Anemia develops when your blood lacks enough healthy red blood cells. Anemia of inflammation (AI, also called anemia of chronic disease) is a common, typically normocytic, normochromic anemia that is caused by an underlying inflammatory disease. Here is the latest research on anemia.

Blood And Marrow Transplantation

The use of hematopoietic stem cell transplantation or blood and marrow transplantation (bmt) is on the increase worldwide. BMT is used to replace damaged or destroyed bone marrow with healthy bone marrow stem cells. Here is the latest research on bone and marrow transplantation.