Pain management in pediatric emergency departments is an area that requires attention, with research playing a crucial role in improving practices. It is essential to ensure that children receive appropriate pain relief during their emergency department visits. However, studies have revealed concerning racial and ethnic disparities in the provision of pain medication to pediatric patients. Minority children are more likely to experience undertreatment of pain compared to their white counterparts, highlighting the need for targeted interventions and awareness of these disparities. Improving the quality of care in pediatric pain management involves implementing evidence-based guidelines, standardized pain assessment tools, and comprehensive education for healthcare providers. Additionally, it is essential to consider the ongoing opioid epidemic while managing pediatric pain. Striking a balance between providing effective pain relief and minimizing the risk of opioid misuse and addiction is crucial. Research can help identify alternative non-opioid pain management strategies, explore multimodal approaches, and develop protocols that promote safe and effective pain relief for children in emergency departments. By addressing racial and ethnic disparities and considering the challenges posed by the opioid epidemic, we can enhance pain management practices, ensure equitable care, and prioritize the well-being of pediatric patients in emergency settings.
Our faculty have participated in several PECARN studies on pain control, including 2 studies evaluating non-opioid-based management of sickle cell pain crises (arginine and magnesium).
Faculty with a research focus on pain and sedation:
- Corrie Chumpitazi, M.D., MS: pain protocols, disparities, sickle cell vaso-occlusive crises
- Email: corriec@bcm.edu
- Twitter: @Pedisedationdoc
- Katherine Guess, M.D.: acute stress disorder after trauma
- Email: Katherine.Guess@bcm.edu
- Kathryn Kothari, M.D.: pain management in the prehospital setting
- Email: kathryn.kothari@bcm.edu
Rees CA, Brousseau DC, Ahmad FA, Bennett J, Bhatt S, Bogie A, Brown KM, Casper TC, Chapman LL, Chumpitazi CE, et al. Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: a multicenter pediatric emergency medicine perspective. Am J Hematol. 2023. PMID 36606705.
Nishijima DK, Tancredi DJ, Adelgais KM, Chadha K, Chang TP, Harris MI, Leonard JC, Lerner EB, Linakis SW, Lowe GS, Magill CF, Schwartz HP, Shah MI, Browne LR. Impact of race and ethnicity on emergency medical services administration of opioid pain medications for injured children. J Emerg Med. 2023. PMID 36641254.
Powell JR, Browne LR, Guild K, Shah MI, Crowe RP, Lindbeck G, Braithwaite S, Lang ES, Panchal AR; Technical Expert Panel. Evidence-based guidelines for prehospital pain management: literature and methods. Prehosp Emerg Care. 2023; PMID 34928783.
Lindbeck G, Shah MI, Braithwaite S, et al. Evidence-based guidelines for prehospital pain management: recommendations. Prehosp Emerg Care. 2023. PMID 34928760.
Rees CA, Brousseau DC, Ahmad FA, Bennett J, Bhatt S, Bogie A, Brown KM, Casper TC, Chapman LL, Chumpitazi CE, et al for the SCD Arginine Study Group and PECARN. Adherence to NHLBI guidelines for the emergent management of vaso-occlusive episodes in children with sickle cell disease: a multicenter perspective. Am J Hematol. 2022. 97(11): e412-e415. PMID 36054566. E-published 9/5/22.
Chumpitazi CE, Chang C, Atanelov Z, et al for the ACEP Pediatric Emergency Medicine Committee. Managing acute pain in children presenting to the emergency department without opioids. J Am Coll Emerg Physicians Open. 2022. PMID 35310402.
Burger RK, Taylor TR, Chumpitazi CE, Robinson LC, Sims MJ, Tunc EM, Mulcrone AE, Caglar D, Sulton CD, Little-Weinert K, Klein EJ, Titus MO, Jackson BF. Pediatric emergency medicine fellowship procedural sedation training: consensus educational guidelines. Pediatr Emerg Care. 2022. PMID 35358144
Chang CD, Saidinejad M, Atanelov D, 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. PMID 34322681.
Crumm CE, Camp EA, Khalil M, Chumpitazi CE. Improving the Pediatric Procedural Experience: An Analysis of Pain, Anxiety, and Satisfaction. J Patient Exp. 2020. PMID: 32851145.
Farr KM, Moffett BS, Jones JL, Rogers AP, Chumpitazi CE. Chloral Hydrate Sedation in a Dexmedetomidine Era. Hosp Pharm. 2020. PMID: 32742011.
Crumm CE, Kaushal S, Chumpitazi CE. Assessing procedural satisfaction in the pediatric ED: A systematic review. Am J Emerg Med. 2020. PMID: 32693939.
Kamat PP, McCracken CE, Simon HK, Stormorken A, Mallory M, Chumpitazi CE, Cravero JP. Trends in Outpatient Procedural Sedation: 2007-2018. Pediatrics. 2020. PMID: 32332053
Kaushal S, Placencia JL, Maffei SR, Chumpitazi CE. Intranasal Fentanyl Use in Neonates. Hosp Pharm. 2020. PMID: 32214447.
Chumpitazi CE, Caviness AC, Grawe GH, Camp EA, Shah MI. Evaluation of Hydrocodone/Acetaminophen for Pediatric Laceration Repair: A Randomized Trial. Plast Reconstr Surg. 2020. PMID: 31881621.
Mace SE, Whiteman P, Avarello JT, Ojo A, Rose E, Valente J, Joseph M. Local and Topical Anesthetics for Pediatric Patients in the Emergency Department. Pediatr Emerg Care. 2020. PMID: 33181789.
