Analgesic provision to pediatric patients with acute abdominal pain in the emergency department: A survey of Canadian pediatric emergency physicians
CPS ePoster Library. Davidson C. Jun 25, 2015; 99213; 151
Chloe Davidson
Chloe Davidson
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Abstract
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Objectives: For Canadian paediatric emergency physicians, we (1) explored practice variation in the provision of analgesia to children with acute undifferentiated abdominal pain, (2) identified reasons for withholding analgesia, and (3) evaluated the relationship between providing analgesia and surgical consultation.

Methods: We prospectively surveyed physician members of the Paediatric Emergency Research Canada (PERC) database. We presented three scenarios of undifferentiated acute abdominal pain to assess management of pain of varying severity. A modified Dillman's Tailored Design method was used to distribute the survey from June to July 2014.

Results: Overall response rate was 75% (149/200); 52% of respondents were female and mean age was 44 + 8.4 years. The reported rates of providing analgesia for cases representative of renal colic, appendicitis, and intussusception, were 100%, 92.1%, and 83.4%, respectively while rates of providing intravenous opioids were 85.2%, 58.6%, and 12.4%, respectively. In all 61 cases where the respondent indicated they would obtain a surgical consultation, analgesia was provided. In the 35 cases where analgesia was withheld, 21 (60%) believed pain was not severe enough, while 5 (14.3%) indicated it would obscure a surgical condition.

Conclusions: The self-reported rates of providing analgesia for acute abdominal pain is higher than previously reported and unrelated to request for surgical consultation. However, unwillingness to provide opioid analgesia, belief that analgesia can obscure a surgical condition, and failure to take self-reported pain at face value remain prevalent, suggesting a need for further knowledge translation efforts.
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