title: Pain Management for Sickle Cell Disease in the Pediatric Emergency Department: Medications and Hospitalization Trends.
abstract: The majority of emergency department (ED) visits and hospitalizations for patients with sickle cell disease (SCD) are pain related. Adequate and timely pain management may improve quality of life and prevent worsening morbidities. We conducted a retrospective chart review of pediatric patients with SCD seen in the ED, selected by sickle cell-related ICD-9 codes. A total of 176 encounters were reviewed from 47 patients to record ED pain management and hospitalization trends. Mean time to pain medication administration was 63 minutes. Patients received combination (nonsteroidal anti-inflammatory drug [NSAID] + narcotic) pain medications for initial treatment at a minority of ED encounters (19%). A higher percentage of patients who received narcotics alone as initial treatment were hospitalized as compared with those who received combination treatment initially ( P= 0.0085). Improved patient education regarding home pain management as well as standardized ED guidelines for assessment and treatment of sickle cell pain may result in superior and more consistent patient care.
authors: 1 Staten Island University Hospital at Northwell Health, Staten Island, NY, USA.|2 McMaster Children's Hospital, Hamilton, ON, Canada.
authors: Chantel
authors: C
authors: Cacciotti
authors: 1 Staten Island University Hospital at Northwell Health, Staten Island, NY, USA.
authors: Sarah
authors: S
authors: Vaiselbuh
authors: 1 Staten Island University Hospital at Northwell Health, Staten Island, NY, USA.
authors: Eleny
authors: E
authors: Romanos-Sirakis
mesh_terms: D000755:Anemia, Sickle Cell / Q000150:complications*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002648:Child; D004636:Emergency Service, Hospital; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009294:Narcotics / Q000627:therapeutic use; D010146:Pain / Q000150:complications* / Q000188:drug therapy*; D059408:Pain Management / Q000379:methods*; D012189:Retrospective Studies
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D009294:Narcotics
keywords: home pain management; sickle cell disease; vaso-occlusive event