Pediatric and Emergency Medicine Resident Comfort Assessing and Treating Pediatric Pain Across Pediatric Age Groups

Abstract

Aim: Assess pediatric and emergency medicine (EM) resident comfort treating and assessing pediatric pain. Materials & methods: Pediatric and EM residents at a single institution (SIUH Northwell Health in New York) completed an anonymous survey 6 months into the academic year regarding comfort assessing and treating pediatric pain. Results: A total of 40 (16/24 EM and 24/24 pediatric) residents completed this survey: 20% (8/24) pediatric first year residents, 40% (16/40) pediatric second year and above, 20% (8/40) EM first year and 20% (8/40) EM second year and above. A 46% (11/24) pediatric and 12% (2/16) EM residents were comfortable assessing neonatal pain (p < 0.05). A 38% (9/24) pediatric residents were comfortable treating neonatal pain compared with 12% (2/16) EM residents (p < 0.05). Both resident groups reported increasing comfort assessing and treating pain with increasing patient age. Conclusion: Both residents groups reported limitations in comfort assessing and treating pediatric pain, especially in younger patients. Education for both groups is important to optimize pediatric pain management.

Plain language summary

Pediatric pain is common, and often underassessed and undertreated. Pediatric and emergency medicine (EM) residents care for pediatric patients with pain and must be able to appropriately assess and treat this pain. For this study, pediatric and EM residents at a single institution (SIUH Northwell Health in New York) completed an anonymous survey 6 months into the academic year regarding comfort assessing and treating pain and comfort prescribing pain medications across pediatric age ranges. In this study, 40 (16/24 EM and 24/24 pediatric) residents completed this anonymous survey. Of the 40 residents, 20% (8/24) were pediatric first year residents, 40% (16/40) were second or third year pediatric residents, 20% (8/40) were EM first year residents and 20% (8/40) were second, third or fourth year residents. About 46% (11/24) of pediatric residents and 12% (2/16) of EM residents were comfortable assessing neonatal pain. With increasing patient age, pediatric residents and EM residents comfort in assessing pediatric pain trended up (93.3% EM residents comfortable assessing pain in teenage patients). About 38% (9/24) of pediatric residents were comfortable treating neonatal pain as compared with 12% (2/16) of EM residents. While pediatric residents were significantly more comfortable treating pain in age categories from neonate to adolescents as compared with EM residents, both pediatric and EM residents reported increasing comfort in treating pediatric pain with increasing patient age. Limitations in comfort assessing and treating pediatric pain exist for both specialties. Education for both groups is important to optimize pediatric pain management.

Keywords::

• acute pain
• pain
• pain assessment
• pain management
• pediatric pain

Author contributions

S Demissie and E Romanos-Sirakis made a substantial contribution to the design of the study, analysis and interpretation of data, drafted and revised the manuscript and approved the version to be published. A Paul and PJ Schmidlein made a substantial contribution to the acquisition of data, drafted and revised the manuscript and approved the version to be published.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.