Evidence map›Paper›PMID 40470289›Full record

ArticlePediatric quality & safety

Reducing Time to Analgesia for Sickle Cell Pain Episode Treatment in the Pediatric Emergency Department.

Amelia F Wong, Jaime K Otillio, Abby K Fahnestock, Christine M Smith, Michael R DeBaun, Emmanuel Volanakis, Lacey Noffsinger, Jeannie Byrd, S Barron Frazier

Abstract read
In one paragraph

Article in Pediatric quality & safety. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Review
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

9 authors.

Amelia F WongFrom the Division of Emergency Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn.
Jaime K OtillioFrom the Division of Emergency Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn.
Abby K FahnestockDepartment of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn.
Christine M SmithDepartment of Pediatrics, Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, Tenn.
Michael R DeBaunVanderbilt-Meharry Center for Excellence in Sickle Disease, Nashville, Tenn.
Emmanuel VolanakisDepartment of Pediatrics, Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, Tenn.
Lacey NoffsingerFrom the Division of Emergency Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn.
Jeannie ByrdDepartment of Pediatrics, Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, Tenn.
S Barron FrazierFrom the Division of Emergency Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Pain episodes are the most common emergency department (ED) presentation for patients with sickle cell disease (SCD). Prompt pain medication and frequent pain assessments are recommended. Our SMART aim was to reduce the time from ED rooming to first analgesia administration for children presenting with SCD pain from 50 to less than 30 minutes by June 2024. Methods: Children presenting to the ED with a diagnosis of SCD requiring opioids for pain were included. The primary outcome was time from rooming to analgesia. A key driver diagram, developed by a multidisciplinary team, informed our interventions and then implemented through plan-do-study-act cycles. Statistical process control charts were used to analyze data with Nelson rules to detect special cause variation. Secondary measures included frequency of pain assessments in the first 2 hours and ED length of stay. Results: From July 2020 to June 2024, there were 447 eligible encounters. Baseline data (n = 143) revealed an average time from ED rooming to analgesia of 50 minutes. Following interventions, including order set implementation, multidisciplinary collaboration, and incorporating the home action plan in the ED, special cause variation was detected with a centerline shift to 32 minutes. The median number of pain assessments in the first 2 hours of arrival improved from 2.2 to 2.7 with order set utilization. ED length of stay remained unchanged. Conclusions: Standardizing care with an order set increased the number of pain assessments. Incorporation of the SCD home pain action plan into the ED treatment pathway decreased the time to analgesia.

Identifiers

PMID40470289
PMCPMC12136660

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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.