Analgesia and Sedation of Pediatric Patients with Major Trauma in Pre-Hospital and Emergency Department Settings—A Narrative Review

Author:

Cohen Neta12ORCID,Cohen Daniel M.3ORCID,Barbi Egidio45ORCID,Shavit Itai67

Affiliation:

1. Pediatric Emergency Medicine Department, Dana Dwek Children’s Hospital, Tel Aviv Sourasky Medical Center, 6 Weizman St, Tel Aviv 6423906, Israel

2. Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel

3. Nationwide Children’s Hospital, The Ohio State University, Columbus, OH 43210, USA

4. Department of Pediatrics, Institute for Maternal and Child Health—IRCCS Burlo Garofolo, 34137 Trieste, Italy

5. Clinical Department of Medical Surgical and Health Science, University of Trieste, 34127 Trieste, Italy

6. Division of Pediatrics, Hadassah Medical Center, Jerusalem 9112001, Israel

7. Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9112102, Israel

Abstract

Children who sustain major injuries are at risk of receiving insufficient pain relief and sedation, which can have physical and psychological repercussions. Heightened emotional distress can increase the likelihood of developing symptoms of post-traumatic stress. Providing sufficient analgesia and sedation for children with major trauma presents specific challenges, given the potential for drug-related adverse events, particularly in non-intubated patients. The current literature suggests that a relatively low percentage of pediatric patients receive adequate analgesia in pre-hospital and emergency department settings following major trauma. There are only sparse data on the safety of the provision of analgesia and sedation in children with major trauma in the pre-hospital and ED settings. The few studies that examined sedation protocols in this context highlight the importance of physician training and competency in managing pediatric airways. There is a pressing need for prospective studies that focus upon pediatric major trauma in the pre-hospital and emergency department setting to evaluate the benefits and risks of administering analgesia and sedation to these patients. The aim of this narrative review was to offer an updated overview of analgesia and sedation management in children with major trauma in pre-hospital and ED settings.

Publisher

MDPI AG

Subject

General Medicine

Reference33 articles.

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