Pediatric emergency care最新文献

{"title":"ESR and CRP Testing in an Urban Emergency Department: Should We Still Be Doing This?","authors":"Salih Demirhan, Mahmoud Ali, Betsy C Herold, David L Goldman","doi":"10.1097/PEC.0000000000003730","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003730","url":null,"abstract":"<p><strong>Objectives: </strong>Pediatricians in the Emergency Department frequently evaluate febrile children. To help identify the cause of fever and assess the severity of the underlying condition, practitioners often utilize erythrocyte sedimentation rate and C-reactive protein testing. While these markers of inflammation are deeply embedded in the practice of pediatrics, they were each developed more than 90 years ago, and their utility to current clinical practice is not well characterized.</p><p><strong>Methods: </strong>We conducted a 1-year retrospective study of children who underwent CRP and ESR testing at an urban Children's Hospital. We recorded and analyzed indications for testing, concordance between testing methods and metrics, including admission status and test performance, as reflected by sensitivity, specificity, and likelihood ratios.</p><p><strong>Results: </strong>ESR and CRP tests were frequently ordered in patients with clinically evident diagnoses. There were no cases of occult bacteremia, and patients with bacteremia typically had presentations indicative of bacterial infection. CRP was superior to ESR as a predictor of bacterial infection; however, the positive likelihood ratio was only 2.1. Combined testing was ordered for 39.4% of all CRP tests, and there was a high concordance (69.9%) between CRP and ESR testing. Combined testing offered limited incremental value for the detection of bacterial infections.</p><p><strong>Conclusions: </strong>CRP and ESR testing are currently overused in our Pediatric Emergency Department, providing limited diagnostic value while adding unnecessary hospital cost. Combined CRP and ESR testing provides limited incremental value. Stewardship of these testing modalities and an active reconsideration of how these tests are employed should be considered.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anaphylaxis in Infants and Toddlers Presenting to a Pediatric Emergency Department.","authors":"Colleen M Shannon, Melissa Trofa, Jane Lavelle, Terri Brown-Whitehorn, Cynthia Jacobstein, Nicholas Tsarouhas, Jennifer Molnar, Antonella Cianferoni, Juhee Lee","doi":"10.1097/PEC.0000000000003728","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003728","url":null,"abstract":"<p><strong>Objective: </strong>To characterize the clinical presentation and management of anaphylaxis in infants and toddlers.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of patients aged 0 to 24 months presenting to a pediatric emergency department between June 2019 and June 2022 with concern for anaphylaxis. Patients were identified using International Classification of Diseases, Ninth and 10th Revision codes associated with anaphylaxis and confirmed to meet 2006 National Institute of Allergy and Infectious Diseases/Food Allergy and Anaphylaxis Network clinical criteria by chart review. Demographic and clinical information-including presenting symptoms, administered treatment, and patient disposition-were abstracted from the electronic medical record. Treatments of interest included epinephrine, antihistamines, corticosteroids, albuterol, and intravenous fluids. Data were analyzed descriptively.</p><p><strong>Results: </strong>Among 225 potentially eligible encounters, we identified 155 patients who met inclusion criteria. Median age was 10.8 months (interquartile range: 8.4 to 15.6). Food triggered 96.1% of episodes. Skin and mucosal symptoms occurred in 99.4% of patients, gastrointestinal symptoms in 74.2%, respiratory symptoms in 57.4%, and cardiovascular symptoms in 5.8%. Intramuscular epinephrine was administered to 87.1% of patients, 90.4% of whom received a single dose. Most patients (88.4%) were discharged home, and none of those admitted required additional epinephrine.</p><p><strong>Conclusions: </strong>In this cohort, reactions were most often food-triggered and characterized by mucocutaneous symptoms with gastrointestinal and/or mild-to-moderate respiratory symptoms. Severe respiratory or cardiovascular involvement was uncommon. Symptoms tended to resolve after a single dose of epinephrine, and most patients were discharged home.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Variability in the Modified Kocher Criteria for Septic Arthritis of the Hip: Implications for Aspiration Decision-Making.","authors":"Sean P Owens, Emily Ho, Sula Frausto, Divya Talwar, Christine M Goodbody, Aaron E Chen, Naomi J Brown","doi":"10.1097/PEC.0000000000003734","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003734","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluates the clinical application of the modified Kocher criteria (MKC) in assessing septic arthritis of the hip (SAH) at a tertiary children's hospital.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on subjects presenting to the emergency department and receiving a hip ultrasound over a 1-year period. Those without a hip effusion were excluded. Patient demographics, symptoms, imaging, labs, treatment, and final diagnoses were collected. SAH was defined clinically by the treating team, supported by patient presentation, lab/imaging findings, operative intervention, and antibiotic therapy. Descriptive and bivariate statistics based on variable distribution were used during analysis.</p><p><strong>Results: </strong>A total of 326 subjects were identified, and 110 had effusion present on ultrasound. Eighteen (16.4%) underwent aspiration. Aspirated subjects had significantly higher cumulative MKC scores (P=0.001) and higher median values for all individual MKC components, including CRP, WBC, ESR, maximum temperature, and a higher prevalence of non-weight-bearing (P<0.05). SAH was diagnosed in 38.9% of the aspirated group (n=7), with MKC scores of 2 (n=2), 3 (n=3), and 5 (n=2). Aspiration rates increased across MKC scores 0 to 3, and synovial fluid inflammatory markers trended higher with increasing MKC scores. Thirteen subjects with an MKC score of 2 were not aspirated; final diagnoses included transient synovitis (n=9), hip effusion, osteomyelitis, sickle cell crisis, or limp (each n=1). Three subjects with an MKC score of 3 were not aspirated and later diagnosed with metastatic tumor, osteomyelitis, and rheumatic fever.</p><p><strong>Conclusions: </strong>Pediatric patients undergoing hip aspiration with a concern for SAH had significantly higher cumulative MKC scores and higher levels of all individual MKC components than their nonaspirated counterparts. However, nearly 15% of patients had MKC scores of 2 or 3 that were not aspirated in the ED, and SAH was identified even in lower-score subjects. While MKC scores appear to influence clinical decision-making, diagnostic variability remains. In patients with intermediate MKC scores of 2 to 3, the criteria should prompt further evaluation, taking into consideration the overall clinical context to guide aspiration decision-making.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Similar Presentations, Divergent Clinical Courses: Pediatric Headache Care in the Emergency Department.","authors":"Suvleen Singh, Alejandro Ramirez, Andrea Rivera-Sepulveda","doi":"10.1097/PEC.0000000000003732","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003732","url":null,"abstract":"<p><strong>Background: </strong>Pediatric emergency department (ED) headache presentations may follow heterogeneous clinical courses.</p><p><strong>Objective: </strong>To compare presentation characteristics, migraine order-set activation, pain-score change, treatment intensity, and health care utilization between pediatric ED headache encounters with and without a clinician-documented persistent/intractable headache.</p><p><strong>Methods: </strong>We conducted a multisite retrospective cross-sectional study of children aged 3 to 18 years presenting to 2 pediatric EDs with headache or migraine as a chief complaint from 2019 to 2023. Encounters were classified by clinician documentation of an intractable/refractory headache diagnosis or persistent symptoms despite initial treatment. The primary outcome was change from arrival to posttreatment/disposition pain score. Sensitivity analyses were restricted to each patient's first encounter and to clinician-documented migraine or status migrainosus.</p><p><strong>Results: </strong>Among 529 encounters, 18.5% had a documented persistent/intractable headache course. Most presentation characteristics were similar, although symptom duration and pulmonary comorbidity differed. Order-set activation did not differ significantly (76.5% vs. 68.2%; P = 0.106). Encounters with a persistent/intractable headache had less pain improvement [median: -4 (interquartile range: -6.75 to -1) vs. -5 (interquartile range: -7 to -3); P = 0.002], received more medications, radiologic imaging (39.8% vs. 26%; P = 0.006), neurology consultation (56.1% vs. 39.4%; P = 0.003), hospitalization (19.4% vs. 3.2%; P < 0.001), and 30-day return ED visits (10.2% vs. 4.6%; P = 0.049). The pain-score difference was attenuated in the first-encounter analysis (P = 0.060), but persisted in the clinician-documented migraine subgroup (P = 0.006).</p><p><strong>Conclusion: </strong>Headache presentation characteristics and order-set activation did not distinguish the ED course, but pain improvement, treatment intensity, and utilization differed during ED care. Prospective studies should evaluate standardized early reassessment measures.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Training and Use of Point-of-Care Ultrasound (POCUS) in Pediatrics and Neonatology in Latin America: A Multinational Survey Study.","authors":"Santiago Minotta Negret, Luis H Llano López, Sydney Goldfeder, Christian H Matteo Morales Morales, Adriana N Rodríguez Chuljak, Kasey A Fuentes Bernal, David P Rojas Flores, César D LLanos Sanclemente","doi":"10.1097/PEC.0000000000003699","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003699","url":null,"abstract":"<p><strong>Objective: </strong>This study characterizes the current state of training, clinical use, and implementation barriers of point-of-care ultrasound (POCUS) in Latin America. POCUS has become a fundamental diagnostic tool. However, limited information exists regarding its implementation in this region.</p><p><strong>Methods: </strong>A multinational cross-sectional survey study was conducted using an electronic survey administered to health care professionals caring for pediatric and neonatal populations across 21 countries in Latin America and the Caribbean (December 2025 to January 2026). We assessed the prevalence of formal training, frequency of clinical use, implementation barriers, and interest in further training. Analyses were performed using epidemiologically appropriate denominators.</p><p><strong>Results: </strong>A total of 662 professionals were included, predominantly pediatric intensivists (45.2%) working in high-complexity settings (73.3%). Formal POCUS training was reported by 68.7%. Overall, 80.4% currently use POCUS; among them, 14.5% reported no formal training. Self-perceived unsupervised competence among trained participants was moderate. The most frequent clinical applications were pleural effusion and cardiac tamponade. The main barriers identified were lack of training (77.5%), limited access to equipment (50.5%), and absence of institutional protocols (48.9%). Interest in formal training was very high (92.9%).</p><p><strong>Conclusions: </strong>Substantial gaps remain in structured education, equipment access, and institutional protocol development. The significant proportion of untrained users and moderate self-perceived competence highlight an urgent need for standardized training programs. The high level of interest in training represents an opportunity to develop coordinated regional strategies to promote safe and effective POCUS implementation in Latin America.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nitrous Oxide Use in Autistic Children: A Descriptive Study.","authors":"Naina Reddy, Nathan Call, Rebecca K Burger","doi":"10.1097/PEC.0000000000003726","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003726","url":null,"abstract":"<p><strong>Objectives: </strong>Describe the population of autistic children who undergo nitrous oxide sedation and the rate of associated adverse events (AEs). Analyze patient- and procedure-level factors associated with AEs in autistic children receiving nitrous oxide outside the dental setting.</p><p><strong>Methods: </strong>A retrospective, descriptive study of autistic children, 3 to 18 years, who received nitrous oxide for procedural sedation during an emergency department or sedation encounter within a single hospital system between January 2014 and December 2023. Data extracted included patient demographics and comorbidities, as well as indication, maximum concentration, duration of administration, and AEs of nitrous oxide. Descriptive statistics were used to summarize the data.</p><p><strong>Results: </strong>Analysis was performed on 186 patients [median age: 8 years (interquartile range: 5.2-12.75), 74.2% male]. Intravenous line placement was the most common indication in all locations. Most received 70% nitrous oxide with a median duration of 6 minutes (interquartile range: 4 -9.75). AEs were rare, occurring in only 3 patients (1.6%), with zero vomiting or aborted procedures. Given the rarity of AEs, no associated factors were able to be identified.</p><p><strong>Conclusions: </strong>Nitrous oxide is a safe, effective, and well-tolerated option for procedural sedation in autistic children, with a low rate of AEs. These findings add to the limited literature supporting its use in nondental settings and suggest it may be a valuable tool for facilitating minor procedures in this population. Future prospective studies are needed to optimize nitrous oxide delivery and determine factors contributing to AEs.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Food Insecurity Screening and Immediate Access to Prepackaged Groceries in the Pediatric Emergency Department: A Pilot Study.","authors":"Hanae Fujii, Brittany Hunter, Samantha Bapty, Nymisha Chilukuri, Laura Davis, Janet R Serwint, Ann Kane, Therese L Canares","doi":"10.1097/PEC.0000000000003722","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003722","url":null,"abstract":"<p><strong>Objective: </strong>Food insecurity (FI) is prevalent in many urban settings across the United States. Many vulnerable families who lack access to a medical home utilize the pediatric emergency department (PED), making the PED a critical access point to address FI. We aimed to understand caregivers' experiences in receiving prepackaged groceries and community resources within a PED.</p><p><strong>Methods: </strong>In this pilot initiative, caregivers who screened positive for FI in the PED received prepackaged groceries for their household and a list of community resources. Caregivers were interviewed to understand their experience in receiving food resources in the PED. Phone interviews were conducted until code saturation was reached. Interviews were recorded, transcribed, and coded. Content analysis generated themes describing the impact of the intervention. This study was conducted in a tertiary care PED in an urban setting between October 2018 and June 2019. Participants included English-speaking caregivers of children younger than 18 years.</p><p><strong>Results: </strong>Ninety-six households received groceries and a list of community food resources. Four themes emerged from interviewing 23 caregivers: (1) immediate food relief was helpful when their child was acutely ill, (2) caregivers generally accepted the food from the prepackaged bags, (3) community resources were difficult to access, and (4) FI households who did not use community resources ascribed this to a lack of need for urgent food.</p><p><strong>Conclusions: </strong>Families perceived benefits of being provided groceries during emergency department visits since there are barriers to accessing community resources.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autonomy in Fellowship Training and Its Influence on Self-Reported Self-Efficacy in Pediatric Emergency Medicine.","authors":"Steven Garbin, Michael J Sheridan, Michelle Eckerle, Frances Turcotte Benedict, Cindy Ganis Roskind, Aline Baghdassarian","doi":"10.1097/PEC.0000000000003721","DOIUrl":"10.1097/PEC.0000000000003721","url":null,"abstract":"<p><strong>Objectives: </strong>This study examined the relationship between autonomy during pediatric emergency medicine (PEM) fellowship and self-efficacy in 6 Accreditation Council for Graduate Medical Education-defined entrustable professional activities (EPAs). We hypothesized that experiencing greater autonomy during fellowship would correlate with higher self-efficacy among current fellows and recent graduates.</p><p><strong>Methods: </strong>An anonymous electronic survey was distributed to current (2021-2022) second- and third-year PEM fellows and first- and second-year PEM attendings who graduated in 2020 and 2021. The survey collected demographic data, self-reported levels of autonomy during fellowship, and self-efficacy ratings for each EPA on a 0 to 100 scale, assessed both currently and retrospectively for 1 year prior. Autonomy was defined as ≥33% of clinical time in indirect supervision or independent practice. Statistical analyses included paired t tests, independent t tests, and multivariate analysis of covariance.</p><p><strong>Results: </strong>One hundred twelve current fellows and 86 recent graduates responded (39% response rate). Both cohorts reported significant self-efficacy improvements across all 6 EPAs over the assessed period ( P <0.001 for all comparisons). No significant differences in self-efficacy gains were observed between those who reported experiencing autonomy during fellowship and those who did not ( P >0.05). In multivariate analysis, prior self-efficacy was the only consistent predictor of current self-efficacy ( P <0.0001), explaining 53% to 71% of variance.</p><p><strong>Conclusions: </strong>This study found no association between self-reported autonomy in PEM fellowship training and self-efficacy in PEM-specific EPAs. Self-efficacy increased over time among all respondents regardless of autonomy experience. These findings suggest that the relationship between autonomy and trainee development may be more complex than previously assumed and warrants further investigation with refined measurement tools.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of Collaborative Assessment and Management of Suicidality-Brief Intervention in an Emergency Department With Youth Who Are Suicidal.","authors":"Morganne Reid, Francesca Fernandez, Jessica Gerner, Raymond Tucker, Claudia R Morris, John Constantino, David A Jobes","doi":"10.1097/PEC.0000000000003719","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003719","url":null,"abstract":"<p><strong>Background: </strong>Emergency departments (EDs) are key entry points for many youth experiencing suicidal thoughts and behaviors into mental health care. ED clinicians play a critical role in crisis intervention, prevention, and linking patients to ongoing care, yet many report uncertainty when assessing for and managing suicidal risk. The Collaborative Assessment and Management of suicidal thoughts and behaviors [Collaborative Assessment and Management of Suicidality (CAMS)] is an evidence-based, suicide-focused intervention that has been adapted into a single session [CAMS-Brief Intervention (CAMS-BI)].</p><p><strong>Objective: </strong>This study tested the use of CAMS-BI with youth who are suicidal and presenting to a pediatric ED.</p><p><strong>Methods: </strong>Participants (aged 12 to 21 y; n = 20) were approached in the ED and completed distress measures before and after CAMS-BI. Following standard discharge timelines was prioritized.</p><p><strong>Results: </strong>Analyses supported CAMS-BI's feasibility for ED youth populations, given the observed low rate of intervention refusal (8.7%) and high completion rate (87%). Participation in the study did not delay ED discharge times. Youth receiving CAMS-BI reported significantly lower distress postintervention, d = 0.45. Three-month follow-up indicated reductions in ED-return rates (0%) compared with youth who did not receive the intervention (15%), and strong patient engagement with outpatient treatment following CAMS-BI was notable (88% attended follow-up appointment).</p><p><strong>Conclusions: </strong>This pilot study provides evidence for CAMS-BI's feasibility for youth in fast-paced ED settings and its clinical value to quickly decrease distress. Future directions include larger, more rigorous replications to fine-tune CAMS-BI implementation into ED workflows.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reporting of Sociodemographic and Equity-Related Factors in Emergency Department Pain Trials for Children: A Scoping Review.","authors":"Elise Kammerer, Samina Ali, Calveen Basi, Patricia Candelaria, Jaspreet K Khangura, Sahra Kaahiye, Leilani Sapon, Lexyn Iliscupidez, Zoe Zelyck, Sarah A Elliott, Liz Dennett, Tehseen Ladha, Maria Mayan, Shannon Scott, Shannon Ruzycki, Lisa Hartling","doi":"10.1097/PEC.0000000000003717","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003717","url":null,"abstract":"<p><strong>Context: </strong>Effective management of children's acute pain in emergency departments (EDs) is essential, yet health disparities exist. The applicability of evidence to diverse pediatric populations depends on clear demographic reporting. The PROGRESS-Plus framework identifies social determinants of health that influence care and outcomes, but it is unclear to what extent randomized controlled trials (RCTs) in pediatric ED pain management report these variables.</p><p><strong>Objective: </strong>This scoping review examines the frequency and completeness of PROGRESS-Plus reporting in RCTs evaluating acute pain interventions for children in EDs in Canada and the USA.</p><p><strong>Data sources: </strong>Using Joanna Briggs Institute methodology and the Participant, Concept, Context framework, we conducted a scoping review of RCTs published between 2013 and 2025. MEDLINE, PsycINFO, CINAHL, and CENTRAL were searched using a peer-reviewed strategy.</p><p><strong>Study selection: </strong>Eligible studies involved children and youth experiencing acute presenting or procedural pain in ED settings. Two reviewers independently screened studies.</p><p><strong>Data extraction: </strong>Data were extracted using standardized forms refined with input from patient partners. Narrative synthesis and descriptive statistics were applied to summarize PROGRESS-Plus reporting.</p><p><strong>Results: </strong>Of 3667 records identified, 65 RCTs met inclusion criteria. Thirty-five studies focused on procedural pain interventions, and 30 on interventions for painful presentations. Age was reported in all studies, and gender and/or sex in 98%. Race and/or ethnicity was reported in 40%, and chronic illness and/or disability in 18%. No studies reported socioeconomic status or place of residence.</p><p><strong>Conclusions: </strong>RCTs addressing pediatric pain in the ED rarely report equity-relevant demographic variables beyond age and gender and/or sex, limiting assessment of intervention effectiveness across diverse populations. Standardized demographic reporting is needed to support equitable, evidence-based pain research and care.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}