Does Age Affect Analgesia Provision at Discharge among Children with Long Bone Fractures Requiring Emergency Care?

BackgroundInadequate treatment of painful conditions in children is a significant and complex problem. The wide range of cognitive abilities associated with a child's age is a particular challenge for providers treating children with painful conditions.Study ObjectiveTo examine the effect of patient age on the provision of analgesic medicines at discharge in children treated emergently for a long bone fracture.MethodsA retrospective review was performed of all patients during a 1-year period with a long bone fracture treated in two urban pediatric Emergency Departments (EDs).ResultsEight hundred seventy-eight patients were identified who met our inclusion criteria. Nearly 60% of patients received a prescription for an opioid-containing medicine and 19% received a prescription for an over-the-counter analgesic medicine at ED discharge. Patients younger than 4 years old had lower pain scores, less severe fractures, and overall were significantly less likely to receive an opioid-containing prescription compared to children 4 years old or greater. In children with more severe fractures requiring reduction in the ED, no significant age-related differences were noted in opioid prescription rates. No age-related significant differences were noted for over-the-counter prescription analgesic medicines provided at discharge.ConclusionYoung patient age is associated with different analgesic prescription patterns in children treated in the ED for a long bone fracture.