Pain management after a fracture is less than optimal for minority kids


A bone fracture is a painful event for all children, but a new study indicates that it could be more painful for some.

Breaking a bone is a painful event for any child, and for some it can even be a defining traumatic moment. However, a new study in Pediatrics indicates that children who are a minority have worse pain management during treatment in the emergency department.1

Investigators did a 3-year retrospective cross-sectional study of children aged younger than 18 years who had long-bone fractures using the Pediatric Emergency Care Applied Research Network Registry, which includes 7 emergency departments. They looked at the association between race and ethnicity and receiving any analgesic, receiving an opioid analgesic, a 2-point or more pain score reduction, and optimal pain reduction, which was mild to no pain.

The sample included 21,069 visits that noted moderate-to-severe pain. During those visits, 86.1% of children were given an analgesic and 45.4% were given an opioid analgesic. Among the 8533 children who had their pain reassessed, 89.2% had a 2-point or more pain score reduction and 62.2% had optimal pain reduction. In comparison with non-Hispanic white children, minority children were more likely to receive any analgesics and have a 2-point or more pain score reduction. However, they also were less likely to be given opioid analgesics or have optimal pain reduction.

The researchers concluded that differences exist in managing pain in children with long-bone fractures due to race and ethnicity. These differences often result in minority children leaving the emergency department in more pain than their white counterparts. Investigators urged more research on the disparities and called for standardized care.





1.    Goyal MK, Johnson TJ, Chamberlain JM, et; Pediatric Emergency Care Applied Research Network (PECARN). Racial and ethnic differences in emergency department pain management of children with fractures. Pediatrics. 2020;145(5): e20193370. doi: 10.1542/peds.2019-3370

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