Parental Presence During Fracture Reduction in Children at the Emergency Department; A Randomized Controlled Trial

Parental Presence During Fracture Reduction in Children at the Emergency Department; A Randomized Controlled Trial

Though much attention has been given to the practice of parental presence during invasive procedures in children in the ED, few studies have examined the patient's perspective. The only study to have addressed this issue used a single visual analog scale, which is not a well validated tool to assess children's distress level. Furthermore, no studies have assessed parental presence during fracture reduction; only a few incidental cases were reported in the literature. Finally, most studies evaluating parental presence had methodological limitations because of the absence of a control group.

The investigators seek to assess whether parental presence during fracture reduction under sedation, in children 8 to 18 years of age, decreases anxiety levels in both parents and children.

Inclusion criteria for patients:

• Patients aged 8 to 18 years old.
• Patients requiring fracture reduction under conscious sedation by emergency department attending physician.
• Patients able to understand basic spoken English or French.

Inclusion criteria for parents:

• Parents able to understand basic spoken English or French.

Exclusion criteria for patients:

• Patients with moderate to severe mental retardation
• Patients with altered mental status or intoxication
• Patients with hemodynamic instability or several traumatic injuries (other than fractures) - these patients require several treatments and may not have time to complete our study.

Exclusion criteria for parents:

• Parents presenting unacceptable behaviors for family presence

  • Uncooperative
  • Physically aggressive, combative
  • Threatening and argumentative
  • Unstable emotionally or cannot be calmed
  • Intoxicated or altered mental status
  • Suspicion of child abuse
  • Suspected perpetrator of violent crime

• Parents with moderate to severe mental retardation.

• Pregnant parent