Analgesia for Children with Acute Abdominal Pain: A Survey of Pediatric Emergency Physicians and Surgeons

2002 ◽  
Vol 9 (5) ◽  
pp. 522-522 ◽  
Author(s):  
S. Galustyan
Keyword(s):  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Pediatric Emergency ◽  
Emergency Physicians

Analgesia for Children With Acute Abdominal Pain: A Survey of Pediatric Emergency Physicians and Pediatric Surgeons

PEDIATRICS ◽  
2003 ◽  
Vol 112 (5) ◽  
pp. 1122-1126 ◽  
Author(s):  
M. K. Kim ◽  
S. Galustyan ◽  
T. T. Sato ◽  
J. Bergholte ◽  
H. M. Hennes
Keyword(s):  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Pediatric Emergency ◽  
Emergency Physicians

scholarly journals Role of emergency physician–performed ultrasound in the differential diagnosis of abdominal pain

2018 ◽  
Vol 27 (2) ◽  
pp. 79-86
Author(s):  
Nalan Kozaci ◽  
Mustafa Avci ◽  
Gul Tulubas ◽  
Ertan Ararat ◽  
Omer Faruk Karakoyun ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Emergency Physician ◽  
Gold Standard ◽  
Acute Abdominal Pain ◽  
Point Of Care ◽  
Final Diagnosis ◽  
Free Fluid ◽  
Emergency Physicians ◽  
Abdominal Ultrasonography

Objectives: This prospective study was performed to evaluate the diagnostic accuracy of bedside point-of-care abdominal ultrasonography performed by emergency physician in patients with non-traumatic acute abdominal pain. Methods: The patients, who were admitted to emergency department due to abdominal pain, were included in this study. The emergency physician obtained a routine history, physical examination, blood draws, and ordered diagnostic imaging. After the initial clinical examinations, all the patients underwent ultrasonography for abdominal pathologies by emergency physician and radiologist, respectively. Point-of-care abdominal ultrasonography compared with abdominal ultrasonography performed by radiologist as the gold standard. Results: The study included 122 patients. Gallbladder and appendix pathologies were the most commonly detected in the abdominal ultrasonography. Compared with abdominal ultrasonography, point-of-care abdominal ultrasonography was found to have 89% sensitivity and 94% specificity in gallbladder pathologies; 91% sensitivity and 91% specificity in acute appendicitis; 79% sensitivity and 97% specificity in abdominal free fluid; 83% sensitivity and 96% specificity in ovarian pathologies. Compared to final diagnosis, preliminary diagnoses of emergency physicians were correct in 92 (75.4%) patients. Conclusion: This study showed that emergency physicians were successful in identifying abdominal organ pathologies with point-of-care abdominal ultrasonography after training.

scholarly journals Abdominal pain: a survey of clinically important outcomes for future research

CJEM ◽  
2010 ◽  
Vol 12 (06) ◽  
pp. 485-490 ◽  
Author(s):  
Angela M. Mills ◽  
Anthony J. Dean ◽  
Judd E. Hollander ◽  
Esther H. Chen
Keyword(s):  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Future Research ◽  
Original Research ◽  
Emergency Physicians ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Clinically Significant

ABSTRACT Objective: We aimed to use the consensus opinion of a group of expert emergency physicians to derive a set of emergency diagnoses for acute abdominal pain that might be used as clinically significant outcomes for future research. Methods: We conducted a cross-sectional survey of a convenience sample of emergency physicians with expertise in abdominal pain. These experts were authors of textbook chapters, peer-reviewed original research with a focus on abdominal pain or widely published clinical guidelines. Respondents were asked to categorize 50 possible diagnoses of acute abdominal pain into 1 of 3 categories: 1) unacceptable not to diagnose on the first emergency department (ED) visit; 2) although optimal to diagnose on first visit, failure to diagnose would not be expected to have serious adverse consequences provided the patient had follow-up within the next 2–7 days; 3) if not diagnosed during the first visit, unlikely to cause long-term risk to the patient provided the patient had follow-up within the next 1–2 months. Standard descriptive statistical analysis was used to summarize survey data. Results: Thirty emergency physicians completed the survey. Of 50 total diagnoses, 16 were categorized as “unacceptable not to diagnose in the ED” with greater than 85% agreement, and 12 were categorized as “acceptable not to diagnose in the ED” with greater than 85% agreement. Conclusion: Our study identifies a set of abdominal pain conditions considered by expert emergency physicians to be clinically important to diagnose during the initial ED visit. These diseases may be used as “clinically significant” outcomes for future research on abdominal pain.

Opioid administration for acute abdominal pain in the pediatric emergency department

2007 ◽  
Vol 3 (1) ◽  
pp. 11 ◽  
Author(s):  
Adi Klein-Kremer, MD ◽  
Ran D. Goldman, MD
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Diagnostic Accuracy ◽  
Acute Abdominal Pain ◽  
Pediatric Emergency ◽  
Current Evidence ◽  
Opioid Analgesia ◽  
Pediatric Emergency Department ◽  
Opioid Administration ◽  
Unclear Etiology

The use of opioid analgesia for acute abdominal pain of unclear etiology has traditionally been thought to mask symptoms, alter physical exam findings, delay diagnosis, and increase morbidity and mortality. However, studies in children and adults have demonstrated that administering intravenous opioids to patients with acute abdominal pain induces analgesia but does not delay diagnosis or adversely affect diagnostic accuracy. This review discusses the effects of opioid administration on pain relief and diagnostic accuracy in children with moderate to severe acute abdominal pain who have been evaluated in the emergency department. We hold that current evidence supports the administration of opioids to children with acute abdominal pain, and future trials will help determine safe and effective timing and dosing related to opioid administration.

scholarly journals Reported provision of analgesia to patients with acute abdominal pain in Canadian paediatric emergency departments

CJEM ◽  
2016 ◽  
Vol 18 (5) ◽  
pp. 323-330 ◽  
Author(s):  
Naveen Poonai ◽  
Allyson Cowie ◽  
Chloe Davidson ◽  
Andréanne Benidir ◽  
Graham C. Thompson ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Overall Response Rate ◽  
Acute Abdominal Pain ◽  
Design Method ◽  
Pediatric Emergency ◽  
Practice Variation ◽  
Paediatric Emergency ◽  
Tailored Design ◽  
The Relationship ◽  
Surgical Condition

AbstractObjectivesEvidence exists that analgesics are underutilized, delayed, and insufficiently dosed for emergency department (ED) patients with acute abdominal pain. For physicians practicing in a Canadian paediatric ED setting, we (1) explored theoretical practice variation in the provision of analgesia to children with acute abdominal pain; (2) identified reasons for withholding analgesia; and (3) evaluated the relationship between providing analgesia and surgical consultation.MethodsPhysician members of Paediatric Emergency Research Canada (PERC) were prospectively surveyed and presented with three scenarios of undifferentiated acute abdominal pain to assess management. A modified Dillman’s Tailored Design method was used to distribute the survey from June to July 2014.ResultsOverall response rate was 74.5% (149/200); 51.7% of respondents were female and mean age was 44 (SD 8.4) years. The reported rates of providing analgesia for case scenarios representative of renal colic, appendicitis, and intussusception, were 100%, 92.1%, and 83.4%, respectively, while rates of providing intravenous opioids were 85.2%, 58.6%, and 12.4%, respectively. In all 60 responses where the respondent indicated they would obtain a surgical consultation, analgesia would be provided. In the 35 responses where analgesia would be withheld, 21 (60%) believed pain was not severe enough, while 5 (14.3%) indicated it would obscure a surgical condition.ConclusionsPediatric emergency physicians self-reported rates of providing analgesia for acute abdominal pain scenarios were higher than previously reported, and appeared unrelated to request for surgical consultation. However, an unwillingness to provide opioid analgesia, belief that analgesia can obscure a surgical condition, and failure to take self-reported pain at face value remain, suggesting that the need exists for further knowledge translation efforts.

Race and Acute Abdominal Pain in a Pediatric Emergency Department

PEDIATRICS ◽  
2013 ◽  
Vol 131 (6) ◽  
pp. 1098-1106 ◽  
Author(s):  
K. Caperell ◽  
R. Pitetti ◽  
K. P. Cross
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department

scholarly journals Point-of-care ultrasound for evaluating intra-abdominal calcification in the pediatric emergency department: case series and review of literature

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Vigil James ◽  
John Samuel ◽  
Chor Yek Kee ◽  
Gene Yong-Kwang Ong
Keyword(s):  
Emergency Department ◽  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Point Of Care ◽  
Pediatric Population ◽  
Pediatric Emergency ◽  
Point Of Care Ultrasound ◽  
Pediatric Emergency Department ◽  
Wall Calcification

Abstract Background The presence of intra-abdominal calcification in the pediatric population can be due to a wide range of conditions. Calcification in the abdomen can be seen in normal or abnormal anatomical structures. In some patients, abnormal calcification points towards the pathology; whereas in others, calcification itself is the pathology. After a thorough history and clinical examination, point-of-care ultrasound (POCUS) would complement the assessment of acute abdominal pain, based on the list of differentials generated as per the abdominal region. The main objective of this article is to review commonly encountered causes of intra-abdominal calcifications in the pediatric population and help in clinical decision-making in a Pediatric Emergency Department. Case presentation We describe a series of pediatric patients who presented to the Pediatric Emergency Department with acute abdominal pain, in whom point-of-care ultrasound helped expedite the diagnosis by identifying varying types of calcification and associated sonological findings. For children who present to the Pediatric Emergency Department with significant abdominal pain, a rapid distinction between emergencies and non-emergencies is vital to decrease morbidity and mortality. Conclusions In a child presenting to the Pediatric Emergency Department with abdominal pain, POCUS and the findings of calcifications can narrow or expand the differential diagnosis when integrated with history and physical exam, to a specific anatomic structure. Integrating these findings with additional sonological findings of an underlying pathology might raise sufficient concerns in the emergency physicians to warrant further investigations for the patient in the form of a formal radiological ultrasound and assist in the patient's early disposition. The use of POCUS might also help to categorize the type of calcification to one of the four main categories of intra-abdominal calcifications, namely concretions, conduit wall calcification, cyst wall calcification, and solid mass-type calcification. POCUS used thoughtfully can give a diagnosis and expand differential diagnosis, reduce cognitive bias, and reduce physician mental load. By integrating the use of POCUS with the history and clinical findings, it will be possible to expedite the management in children who present to the Pediatric Emergency Department with acute abdominal pain.

Sign in / Sign up

Export Citation Format

Share Document