Table 2.

Most commonly used methods for the management of a hypothetical patient presenting to a European emergency department with a forearm fracture requiring painful reduction and casting

Method	Number of sites (n = 156)a	Number of children represented (n = 4,578,308)
Intravenous sedation in the emergency department	84 (54%)	2,811,926 (61%)
Nitrous oxide +/− hematoma block +/− intranasal fentanyl)	33 (21%)	1,151,515 (25%)
Procedure done under general anesthesia by anesthesiologist	59 (38%)	1,120,033 (25%)
Intranasal fentanyl +/− intranasal midazolam	23 (15%)	458,096 (10%)
No inhaled, intravenous, or intranasal medications	8 (5%)	350,963 (8%)
Analgesia and transfer to a referral center	9 (6%)	158,000 (3%)
Intramuscular sedation in the emergency department	3 (2%)	45,200 (1%)

Ranked from most to least common. ^aFifteen sites representing 398,273 patients were excluded as they reported that they did not see trauma cases at their site (patients were referred elsewhere from scene of injury). The total is > 100% as several management options could be selected by a single site