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Prehospital Pain Management in Children With Traumatic Injuries

Rutkowska, Anna PhD; Skotnicka-Klonowicz, Grażyna MD, PhD

doi: 10.1097/PEC.0000000000000313
Original Articles

Summary: Damage that arises as a result of injuries is one of the most common causes of children presenting to hospital emergency departments.

Objectives: The aim of the study was to assess the implementation of recommendations for prehospital pain management in injured children provided by various health care centers.

Methods: A total of 7146 children aged 0 to 18 years because of injury were admitted to the Department of Paediatric Emergency Medicine in the Maria Konopnicka Memorial University Teaching Hospital No. 4 in Lodz within the period of 12 months. From this group, 1493 children received prehospital emergency care from various health care centers.

Results: Health care centers provided prehospital aid to 21% of all children with injuries. Boys (60.3%) and children older than 5 years (80%) predominated among pediatric trauma cases. Prehospital emergency aid was most frequently administered to children by emergency medical services personnel (42.7%) and a primary health care physician (28.1%). Injuries of head (42.1%), neck (1.1%), chest (1.7%), abdomen (2.5%), upper (32.2%), and lower (19.9%) limbs as well as burns (5.3%) were diagnosed in pediatric patients. Indications for prehospital analgesia were found in 489 of 1493 patients (32.7%). Analgesia was administered to 159 children (32%), pain medication was not given to 223 children (46%), and in 107 cases (22%), there was a lack of information on that subject.

Conclusions: Despite the training of medical staff, provision of analgesia for children with burns and traumatic injuries of the osteoarticular system is inadequate.

From the Department of Paediatric Emergency Medicine, Medical University of Lodz, Faculty of Health Sciences, Lodz, Poland.

Disclosure: The authors declare no conflict of interest.

Reprints: Anna Rutkowska, MD, PhD, Department of Paediatric Emergency Medicine, Maria Konopnicka Memorial University Teaching Hospital No. 4, 90-738 Lodz ul. Sporna 36/50, Lodz, Poland (e-mail:

The study was financed by: (1) The Medical University of Lodz within the programme for PhD students development no. 502-03/8-000-03/502-64-029. (2) The European Social Fund and the State Budget within the Action 2.6 of the Integrated Regional Development Operational Programme in relation to the implementation of the project entitled “Scholarships Supporting Innovative Research of PhD Students.”

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