title: Does age affect analgesia provision at discharge among children with long bone fractures requiring emergency care?
abstract: BACKGROUND
  Inadequate 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.
  
  
  OBJECTIVE
  To examine the effect of patient age on the provision of analgesic medicines at discharge in children treated emergently for a long bone fracture.
  
  
  METHODS
  A 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).
  
  
  RESULTS
  Eight 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.
  
  
  CONCLUSIONS
  Young patient age is associated with different analgesic prescription patterns in children treated in the ED for a long bone fracture.
authors.affiliation: Department of Emergency Services, Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota.
authors.forename: Henry W
authors.initials: HW
authors.lastname: Ortega
authors.forename: Heidi
authors.initials: H
authors.lastname: Vander Velden
authors.forename: Chia-Wei
authors.initials: CW
authors.lastname: Lin
authors.forename: James A
authors.initials: JA
authors.lastname: Engels
authors.forename: Samuel
authors.initials: S
authors.lastname: Reid
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D050723:Fractures, Bone / Q000150:complications* / Q000628:therapy; D006801:Humans; D008297:Male; D004366:Nonprescription Drugs / Q000627:therapeutic use; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement; D010351:Patient Discharge; D012189:Retrospective Studies; D019037:Urban Health Services; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D004366:Nonprescription Drugs
keywords: age; analgesia; fractures; pediatric