Physician Perspectives on Acupuncture Use in the Pediatric Emergency Department

Objectives Acupuncture is a nonpharmalogical treatment modality that is used to treat pain. Prior research demonstrates that pediatric patients tolerate acupuncture well and patients may experience significant pain relief. The objectives of this study were to (1) explore the experiences of pediatric emergency department (ED) physicians as they used 2 acupuncture procedures, Battlefield Acupuncture and Four Gates procedures, and (2) describe factors impacting the feasibility of acupuncture implementation in the pediatric ED setting. Methods This qualitative study used individual semistructured interviews with pediatric emergency medicine physicians who had completed basic acupuncture training recruited using purposive sampling. Interviews were individually coded and analyzed using thematic analysis. Results Eight pediatric ED physicians participated in interviews. We identified multiple factors that promoted acupuncture use, multilevel barriers that impacted ED acupuncture implementation, offered multilevel solutions to overcome barriers to ED acupuncture implementation, and overall recommended continued use of ED acupuncture. Participants noted that education for patients, families, ED staff, and the general community may facilitate acupuncture implementation. To promote standardized and equitable access to acupuncture, participants recommended that all ED physicians in the division should be credentialed to provide acupuncture. In addition, participants recognized the benefits of an ED-specific electronic medical record documentation template and acupuncture toolbox including centralized acupuncture supplies, patient and family educational materials, and reference cards for physicians. Conclusions Participants overall had positive experiences with ED acupuncture. Although multilevel barriers to use of acupuncture were noted, these may be mitigated by several strategies suggested by participants. Future research is needed to further explore the potential impact of these strategies, as well as examine clinical outcomes of acupuncture implementation in the pediatric ED setting.

[1]  M. Connelly,et al.  Development and Assessment of an Abbreviated Acupuncture Curriculum for Pediatricians. , 2021, Academic pediatrics.

[2]  K. Billings,et al.  Standardized Order Set Exhibits Surgeon Adherence to Pain Protocol in Pediatric Adenotonsillectomy , 2020, The Laryngoscope.

[3]  M. Licursi,et al.  Acupuncture for pediatric sickle cell pain management: A promising non-opioid therapy. , 2020, Complementary therapies in medicine.

[4]  Lyn M. Balsamo,et al.  Improving Care for Sickle Cell Pain Crisis Using a Multidisciplinary Approach , 2019, Pediatrics.

[5]  D. Federman,et al.  Challenges and Strategies for Implementing Battlefield Acupuncture in the Veterans Administration: A Qualitative Study of Provider Perspectives. , 2018, Medical acupuncture.

[6]  J. Tsung,et al.  Acupuncture as a Nonpharmacologic Treatment for Pain in a Pediatric Emergency Department , 2018, Pediatric emergency care.

[7]  Katerina Lin,et al.  Integrating Acupuncture for the Management of Costochondritis in Adolescents. , 2017, Medical acupuncture.

[8]  Likang Xu,et al.  Annual surveillance report of drug-related risks and outcomes -- United States, 2017 , 2017 .

[9]  S. Humiston,et al.  Increasing ED Use of Jet Injection of Lidocaine for IV-Related Pain Management , 2017, Pediatrics.

[10]  M. McDonald,et al.  Auricular Acupuncture for the Treatment of Pediatric Migraines in the Emergency Department , 2016, Pediatric emergency care.

[11]  J. Gold,et al.  Effects of acupuncture on pain and inflammation in pediatric emergency department patients with acute appendicitis: a pilot study. , 2015, Journal of alternative and complementary medicine.

[12]  S. Lotfipour,et al.  Prescription Drug Monitoring Programs and Other Interventions to Combat Prescription Opioid Abuse , 2011, The western journal of emergency medicine.

[13]  P. Harris,et al.  Research electronic data capture (REDCap) - A metadata-driven methodology and workflow process for providing translational research informatics support , 2009, J. Biomed. Informatics.

[14]  T. Buclin,et al.  Oligoanalgesia in the emergency department: short-term beneficial effects of an education program on acute pain. , 2007, Annals of emergency medicine.

[15]  Mark Payne,et al.  Health and Human Services , 2020, Congress and the Nation 2013-2016, Volume XIV: Politics and Policy in the 113th and 114th Congresses.

[16]  NIH Consensus Conference. Acupuncture. , 1998, JAMA.