A randomized clinical trial of Oral analgesics Utilization for CHildhood musculoskeletal injuries (The OUCH Trial)

Pain management of children presenting to the Emergency Department (ED) with a trauma to a limb is poorly treated even though musculoskeletal traumas (e.g. fractures, severe sprains) are considered to generate moderate to severe pain intensity. In spite of the fact that pain is considered one of the main symptoms for which children present to the ED, pain treatment remains suboptimal. In fact, children are less likely to receive an analgesic, and especially a strong analgesic, when compared to adults with similar traumas. This study aimed to improve pain treatment of children presenting to the ED with a musculoskeletal trauma to an arm or a leg. We will compare two different analgesic treatments (experimental) to a standard treatment (control) to find out if one of the experimental treatments controls the pain better than the standard treatment. Our secondary aim is to demonstrate that both treatments are safe to be administered to children and that they cause minimal side effects while providing adequate pain relief. We strongly believe that children should receive a better treatment for their pain. Adequately relieving acute pain in children is critical. Inadequate pain treatment can have detrimental effects; it can result in extended length of hospitalization, slower healing, emotional trauma, suffering, and altered pain processing in adulthood by decreasing the pain stimulus threshold of children. It also generates unnecessary stress in both the children and parents, and increases the risk of developing chronic pain on the long term. Given this knowledge, we feel that our study will provide evidence that will translate to an improvement of clinical practices regarding pain treatment of children with musculoskeletal traumas in the ED.