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