An Assessment of Child Life Service and Pain Management in Pediatric Trauma Patients.

OBJECTIVE

The objective of this study is to investigate differences in pain outcomes for pediatric trauma patients who receive Child Life Services versus pediatric trauma patients who do not.

METHODS

Retrospective chart reviews were completed on patients birth to 21 years of age who were seen by trauma services in the Emergency Department and various inpatient units. These individuals were characterized into 2 groups: those seen by child life specialists and those who were not. Pain scores were recorded by using the following scales: face, legs, activity, cry, consolability (FLACC), The Wong-Baker FACES, the Verbal Numeric Rating Score, and Critical Care Pain Observation Tool (CPOT). Baseline data included age, sex, race, injury type, Injury Severity Score (ISS), pain score, and length of stay. Patients were matched using the initial pain score and ISS score. An ordinal logistic model was built regressing pain at discharge on group (CLS visit or no CLS visit). Significance was set at P ≤0.05.

RESULTS

One hundred ninety-six patients' data were used; 107 (54%) of them had been seen by child life specialists. The study groups had similar baseline demographics and injury severity scores. The pain score at discharge was significantly lower in children with child life services' visits (median=0, min=0, max=10) compared with those without [median=2, min=0, max=10; OR=0.48, 95% CI (0.28, 0.83), P =0.009].

CONCLUSIONS

Certified child life specialist involvement in pediatric trauma patients' care correlates to a lower pain score upon discharge.