This video is a part of our Pain Series. In this episode, Dr. Corrie Chumpitazi gives an overview of pediatric pain management in the emergency department context, with a focus on education and advocacy toolkits for pediatric pain management that can be used nationwide. She discusses how to optimize both recognition and management of pediatric pain, with practical tips for determining medication selection and mitigating bias. She also talks about the use of opioids in treating pediatric pain, with consideration of healthcare disparities and changes in prescribing practices over time.
The Pain Series is funded through the generosity of the MAYDAY Fund, which has, over the years, supported investigators and projects that have dramatically improved the pain management of children throughout the world.
Upon viewing this presentation, participants will be able to:
• Describe available approaches to assessing pediatric pain in the emergency department
• Identify available tools for the recognition and management of pediatric pain
• Discuss the role of opioids in treating pediatric pain, with consideration of changes in opioid prescribing practices over time
• Identify racial and ethnic disparities in the treatment of pediatric pain
CHAPTERS
00:00 Introduction
01:59 Key issues in pediatric pain management
04:19 How to appropriately assess pain
07:22 Pain management kits
15:23 How pain kits are utilized
17:05 Opioid discussion
19:16 Optimal health equity between patients with disparities
22:44 Summary
DATES
Initial Publication: March 8, 2023.
ARTICLES REFERENCED
• Ali S, Morrison E, Shwetz S, Yaskina M, Rajagopal M, Estey A, Drendel AL. An assessment of the psychometric properties of the Stoplight Pain Scale in a Canadian paediatric emergency department. Paediatr Child Health. 2021 May 26;26(7):421-427. (6:37)
• Chang CD, Saidinejad M, Atanelov Z, Dietrich AM, Lam SH, Rose E, Ruttan T, Shahid S, Stoner MJ, Sulton C, Chumpitazi CE; ACEP Pediatric Emergency Medicine Committee. Emergency department strategies to combat the opioid crisis in children and adolescents. J Am Coll Emerg Physicians Open. 2021 Jul 21;2(4):e12512.
• Chumpitazi CE, Chang C, Atanelov Z, et al. Managing acute pain in children presenting to the emergency department without opioids. J Am Coll Emerg Physicians Open. 2022;3(2):e12664. (18:14)
• Goyal MK, Drendel AL, Chamberlain JM, et al. Racial/Ethnic Differences in ED Opioid Prescriptions for Long Bone Fractures: Trends Over Time. Pediatrics. 2021;148(5):e2021052481. (19:45)
• Groenewald CB, Rabbitts JA, Gebert JT, Palermo TM. Trends in opioid prescriptions among children and adolescents in the United States: a nationally representative study from 1996 to 2012. Pain. 2016;157(5):1021-1027. (10:30)
• Johnson TJ, Winger DG, Hickey RW, et al. Comparison of Physician Implicit Racial Bias Toward Adults Versus Children. Acad Pediatr. 2017;17(2):120-126. (21:57)
• Kircher J, Drendel AL, Newton AS, et al. Acute pediatric musculoskeletal pain management in North America: a practice variation survey. Clin Pediatr (Phila). 2014;53(14):1326-1335 (16:48)
• Tobias JD, Green TP, Coté CJ; SECTION ON ANESTHESIOLOGY AND PAIN MEDICINE; COMMITTEE ON DRUGS. Codeine: Time to Say "No". Pediatrics. 2016;138(4):e20162396. (11:03)
ADDITIONAL REFERENCES
• Emergency Medical Services for Children Innovation & Improvement Center (EIIC) toolkits (emscimprovement.center/educat...)
• EIIC/TREKK: Bottom Line Recommendations Pain Treatment (emscimprovement.center/educat...)
• Pediatric Education and Advocacy Kit (PEAK) toolkits: (emscimprovement.center/educat...)
• Stoplight Pain Scale (stoplightpainscale.com/)
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CITATION
Chumpitazi CE, Perez C, Daniel D, Wolbrink TA. Pediatric pain management in the emergency department. 3/2023. Online Video. OPENPediatrics. • Pediatric Pain Managem... .