Characterizing Pain in Children with Acute Gastroenteritis Who Present for Emergency Care - 22/03/21
, Claudia Maki, BN 3, Jianling Xie, MD, MPH 5, Bonita E. Lee, MD, MSc 1, 3, 4, James Dickinson, MBBS, PhD 6, Shannon E. MacDonald, PhD, RN 1, 3, 4, 7, 8, 9, Naveen Poonai, MD, MSc 10, Jennifer Thull-Freedman, MD 11, 12, 13, Otto Vanderkooi, MD 14, Manasi Rajagopal, MBT 1, 3, Mithra Sivakumar, BN 1, 3, Linda Chui, PhD 15, 16, 17, Timothy A.D. Graham, MD, MSc 2, 3, Alberto Nettel-Aguirre, PhD, PStat 6, Lawrence W. Svenson, PhD 18, Stephen B. Freedman, MDCM, MSc 11, 12, 13on behalf of
the Alberta Provincial Pediatric EnTeric Infection TEam (APPETITE Team) and Pediatric Emergency Research Canada (PERC)
Abstract |
Objective |
To characterize the pain experienced by children with acute gastroenteritis (AGE) in the 24 hours before emergency department (ED) presentation. Secondary objectives included characterizing ED pain, discharge recommendations, overall analgesic use, and factors that influenced analgesic use and pain severity.
Study design |
A prospective cohort was recruited from 2 pediatric EDs (December 2014 to September 2017). Eligibility criteria included <18 years of age, AGE (≥3 episodes of diarrhea or vomiting in the previous 24 hours), and symptom duration <7 days at presentation.
Results |
We recruited 2136 patients, median age 20.8 months (IQR 10.4, 47.4) and 45.8% (979/2136) female. In the 24 hours before enrollment, most caregivers reported moderate (28.6% [610/2136, 95% CI 26.7-30.5]) or severe (46.2% [986/2136, CI 44.0-48.3]) pain for their child. In the ED, they reported moderate (31.1% [664/2136, 95% CI 29.1-33.1]) or severe ([26.7% [571/2136, 95% CI 24.9-28.7]) pain; analgesia was provided to 21.2% (452/2131). The most common analgesics used in the ED were acetaminophen and ibuprofen. At discharge, these were also most commonly recommended. Factors associated with greater analgesia use in the ED were high pain scores during the index visit, having a primary care physician, earlier presentation to emergency care, fewer diarrheal episodes, presence of fever, and hospitalization at index visit.
Conclusions |
Most caregivers of children presenting to the ED with AGE reported moderate or severe pain, both before and during their visit. Future research should focus on the development of effective, safe, and timely pain management plans.
Le texte complet de cet article est disponible en PDF.Key words : distress, analgesia, vomiting, diarrhea, emergency department, pediatrics
Abbreviations : ACH, AGE, ED, SCH, VNRS
Plan
| Funded in part by the Alberta Provincial Pediatric EnTeric Infection TEam, which is supported by an Alberta Innovates Collaborative Research Innovation Opportunity (CRIO). Alberta Provincial Pediatric EnTeric Infection TEam is also supported by the Alberta Children's Hospital Research Institute (Calgary, Alberta) and the Women and Children's Health Research Institute Partnership Award (Edmonton, Alberta). S.F. is supported by the Alberta Children's Hospital Foundation Professorship in Child Health and Wellness. The authors declare no conflicts of interest. |
|
| Portions of this study were presented at the Canadian Paediatric Society 96th Annual Conference, June 6-8, 2019, Toronto, Ontario; and the Canadian Association of Emergency Physicians Annual Meeting, May 26-29, 2019, Halifax, Nova Scotia. |
Vol 231
P. 102 - avril 2021 Retour au numéro
Article précédent
- Cost Analysis of Emergency Department Criteria for Evaluation of Febrile Infants Ages 29 to 90 Days
- Courtney Coyle, Guy Brock, Rebecca Wallihan, Julie C. Leonard
- 50 Years Ago in The Journal of Pediatrics : Syndromic Intellectual Disability: A Never-Ending Genomic Odyssey
- Mounika Endrakanti, Neerja Gupta, Piyush Gupta
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?