Abstract
ObjectiveTo describe temporal trends and factors associated with opioid administration among children discharged from the emergency department (ED) after a trauma visit.MethodsThis was a cross-sectional study of ED visits for children <19 years old who received a trauma-related diagnosis and were discharged from the ED. Data were obtained from the National Hospital Ambulatory Medical Care Survey 2006–2015.Outcome measuresAdministration of an opioid medication either during the ED visit or as a discharge prescription. Survey-adjusted regression analyses were used to determine the probability of a patient receiving an opioid medication.ResultsDuring the study period, there were 19,241 pediatric trauma visits discharged from the ED, of which 14% were associated with an opioid. Opioid administration decreased by nearly 30% during the study period (p<0.001 for trend). In multivariable analysis, patient factors associated with opioid administration were adolescent age, evening visit, region of the country, and severe pain score. The diagnosis associated with the most opioids was ankle sprain and the diagnosis with the highest rate of opioid administration was radius fracture. The most common opioid administered to children under 12 years of age was acetaminophen-codeine.ConclusionsOpioid administration appears to be decreasing among pediatric patients presenting to the ED with trauma, but a high number of children continue to be exposed to opioids every year. Further education on opioid sparing pain management strategies may be warranted to decrease opioid exposure, including the inappropriate use of codeine, in this low risk trauma population.
Highlights
The opioid crisis in the United States (US) affects people of all ages, including children and adolescents
There were 19,241 pediatric trauma visits discharged from the emergency department (ED), of which 14% were associated with an opioid
Opioid administration appears to be decreasing among pediatric patients presenting to the ED with trauma, but a high number of children continue to be exposed to opioids every year
Summary
The opioid crisis in the United States (US) affects people of all ages, including children and adolescents. Much of the literature on opioid use has focused on the adult patient population. Adolescents are especially vulnerable to misuse of prescription medications.[1] Even short-term prescriptions are associated with misuse for certain youth.[2] from 2012–2016, unintentional deaths from poisoning, including opioid-related deaths, became the leading cause of unintentional injury death in those 15–34 years of age.[3] Taken together, these studies suggest that efforts aimed at minimizing opioid exposures among children may have important public health implications
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