Current Trends in the Management of Common Painful Conditions of Preschool Children in United States Pediatric Emergency Departments

Abstract

Trends in pain management practice by Pediatric Emergency Medicine fellows in the United States were described and analyzed. Self-administered surveys on pain management practices conducted among Pediatric Emergency Medicine fellows at the national Pediatric Emergency Medicine fellows' annual conference in 1996 and 2004 were compared. In comparison to the 1996 survey, the 2004 survey noted a significant increase in narcotics use for headache (6% versus 12%; P = .001), abdominal pain (4% versus 50%; P = .001), and burn patients (46% versus 68%; P = .001). There was also an increase in reported use of topical/ local anesthetics for venipuncture (6% versus 18%, P = .001) and lumbar puncture (49% versus 80%; P = .001), and ketamine for repairing lacerations (16% versus 56%; P = .001), incision and drainage (12% versus 58%; P = .001), and reduction of fractures (38% versus 79%; P = .001). The reported use of pain medication use by Pediatric Emergency Medicine fellows increased during the study period.