Evidence map›Paper›PMID 36852187›Full record

ArticleJournal of the American College of Emergency Physicians open2023

Do kids with forearm fractures need opioids at discharge from the emergency department? Analgesic prescribing and pain control following closed reduction of pediatric forearm fractures.

Richard E Jernigan, Lukas G Keil, Sahil Dadoo, Cheryl L Jackson, Anna D Vergun

Open access · goldAbstract read
In one paragraph

Article in Journal of the American College of Emergency Physicians open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.7field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Richard E JerniganMedical Doctorate Program University of North Carolina School of Medicine Chapel Hill North Carolina USA.
Lukas G KeilDepartment of Orthopaedics University of North Carolina School of Medicine Chapel Hill North Carolina USA.
Sahil DadooDepartment of Orthopaedics University of North Carolina School of Medicine Chapel Hill North Carolina USA.
Cheryl L JacksonDepartments of Pediatrics and Emergency Medicine University of North Carolina School of Medicine Chapel Hill North Carolina USA.
Anna D VergunDepartment of Orthopaedics University of North Carolina School of Medicine Chapel Hill North Carolina USA.
University of North Carolina at Chapel Hill · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: The purpose of this 2-part study is to determine opioid prescribing patterns and opioid use and pain control after discharge following closed reduction of pediatric forearm fractures. Methods: A retrospective study was conducted from December 2016 to January 2018 at a level 1 trauma center to determine opioid prescribing habits for patients 1-17 years old with forearm fractures treated with closed reduction. A prospective study was then conducted from August 2019 to October 2020 to determine pain control and opioid use after discharge. Data were collected through chart review and with telephone surveys on post-discharge days 1, 3, and 5 to collect pain scores and opioid use. Results: Fifty patients with a median age of 8 (interquartile range [IQR], 5-11) years old and 51 patients with a mean age of 9 (IQR, 6-11) years old were included in the retrospective and prospective cohorts, respectively. From the retrospective study, 21 patients (42%) were prescribed a median of 10 opioid doses (IQR, 8-12) at discharge. From the prospective study, 12 patients (24%) were discharged with a median of 8 opioid doses (IQR, 5.5-10), for a total of 98 total doses. Of those, only 7 doses (7%) were used by 3 patients. Higher weight and initial pain score were associated with increased rates of opioid prescription. Conclusions: Pediatric patients who undergo closed reduction of a forearm fracture under procedural sedation in the emergency department are prescribed approximately 14 times the amount of opioid that is used. We propose that prescribing only non-opioid analgesics to these patients would afford equivalent pain control without the side-effects and abuse potential of opioid use at an early age.

Indexed as

analgesicsclosed reductionforearm fractureopioidspainpain managementpediatricsradius fractureulna fracture

Identifiers

PMID36852187
PMCPMC9958247
OpenAlexW4322007962

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.