Timeliness and Adherence to Opioid Administration Guidelines for Acute Sickle Cell Pain in Pediatric Patients: A Comparison of Pediatric and Adult Emergency Departments.

We leveraged the Epic Cosmos database to compare the timeliness of opioid administration for children with sickle cell disease pain in pediatric and adult emergency departments (EDs). Our analysis of 44,415 ED visits from 2019 to 2025 demonstrated that median times to the first and second opioid doses were substantially shorter in pediatric EDs (44 and 38 min, respectively) compared with adult EDs (76 and 78 min, respectively). Adherence to national guidelines recommending pain treatment within one hour of arrival was higher in pediatric EDs (64.9%) compared with adult EDs (37.3%). These results underscore significant disparities in care.