• Shiliang Alice Cao, Kristina Monteiro, and Hale Wills.
• Primary Care-Population Medicine, Alpert Medical School of Brown University, 222 Richmond St, Providence, RI, U.S.A. 02903; Alpert Medical School of Brown University, 222 Richmond St, Providence, RI, U.S.A. 02903. Electronic address: shiliang_cao@alumni.brown.edu.
• J. Pediatr. Surg. 2020 Aug 1; 55 (8): 1585-1589.

IntroductionTrauma is the leading cause of mortality among children in the US. Injured children often receive narcotic pain medication throughout their hospital stays and upon discharge from pediatric trauma centers. While effective, narcotics carry significant risks. There is a dearth of knowledge regarding narcotic education, prescribing practices, and pain management training at pediatric trauma centers. We hypothesize that there is a lack of standardization in these practices among pediatric trauma centers nationally.MethodsA national survey was sent to medical directors at ACS-verified and state designated level 1 and 2 pediatric trauma centers. Data were collected over 6 months on discharge narcotic education and prescribing practices.ResultsOf 97 surveys sent, 92 were returned (94.8% response). Responses show that narcotics are most commonly prescribed by residents (79.1%). Electronic Medical Record (EMR) prescribing is common (89.2%); however, only 1.75% of EMRs give recommendation to prescribe naloxone. Only 9.7% report a standardized format of narcotic education. Most healthcare staff providing narcotic education receive no training in nonpharmacological pain management (68.8%). Most centers report no formal process to reduce the quantity of discharge narcotics prescribed (71.0%). Respondents report many barriers to providing discharge narcotic education to patients and families, including staff training on how to provide discharge narcotic education, staff availability, patient/ parent literacy, and format of available educational resources.ConclusionThe study results show that there is lack of standardization in discharge narcotic education and prescription practices among pediatric trauma facilities nationally and highlight the need for a standardized narcotic prescribing and management protocol. Despite the growing national concern of opiate misuse, particularly among children, respondents report inability to deliver adequate narcotic education owing to various communication and systems barriers.Type Of StudyCross-sectional survey.Level Of EvidenceLevel IV.Copyright © 2019 Elsevier Inc. All rights reserved.

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