Acute pain research and marginalized children in the emergency setting: a scoping review.

BACKGROUND

Pediatric pain is prevalent in emergency departments (EDs). Marginalized children are disproportionately affected by disparities in pain care.

OBJECTIVES

This scoping review maps the extent and nature of the literature concerning the pain care of marginalized children in the ED.

DATA SOURCES: We searched MEDLINE, PsycINFO, CINAHL, Web of Science, iPortal, Native Health Database, and CENTRAL.

STUDY ELIGIBILITY CRITERIA: Studies published between 2013 and 2025.

PARTICIPANTS AND INTERVENTIONS: Children/youth with pain or undergoing painful procedures in US or Canadian EDs; populations defined by at least one PROGRESS-Plus factor, an internationally recognized framework to identify characteristics that may be associated with inequities in healthcare.

STUDY APPRAISAL AND SYNTHESIS

METHODS

De-duplicated results from searching were screened in two stages by two reviewers in Covidence, with disagreements resolved through consensus, or a third reviewer. Data were charted using standard forms in Microsoft Excel. We extracted all PROGRESS-Plus criteria quantified in the studies.

RESULTS

From 3,056 identified records, we included 33 studies, all conducted in the US. Most (31/33) were retrospective studies. Child age was reported in all studies, race/ethnicity in 97% (32/33), and gender/sex in 94% (31/33). All studies concerned presenting pain; none explored procedural pain.

LIMITATIONS: We only searched for literature conducted in Canada and the US and did not include studies documenting general care inequities.

CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: Current research on marginalized children's pain in the ED is dominated by retrospective American studies using administrative data that focus on racial/ethnic disparities.

SCOPING REVIEW REGISTRATION NUMBER: 10.1371/journal.pone.0296518.