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Survey of pain etiology, management practices and patient satisfaction in two urban emergency departments

Published online by Cambridge University Press:  21 May 2015

Knox H. Todd*
Affiliation:
Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Ga.
Edward P. Sloan
Affiliation:
Department of Emergency Medicine, University of Illinois College of Medicine, Chicago, Ill.
Connie Chen
Affiliation:
Pharmacia, Inc.
Stephen Eder
Affiliation:
Department of Emergency Medicine, University of Illinois College of Medicine, Chicago, Ill.
Kyle Wamstad
Affiliation:
Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Ga.
*
Emory University School of Medicine, 1101 Juniper St. NE, Ste. 913, Atlanta GA 30309 USA; 404 872-5740, fax 404 872-5747, ktodd@sph.emory.edu

Abstract:

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Objective:

The underuse of analgesics, or “oligoanalgesia,” is common in emergency departments (EDs). To improve care we must understand our patients’ pain experiences as well as our clinical practice patterns. To this end, we examined pain etiology, pain management practices and patient satisfaction in 2 urban EDs.

Methods:

We conducted a cross-sectional study using structured interviews and chart reviews for patients with pain who presented to either of 2 university-affiliated EDs. We assessed pain etiologies, patient pain experiences, pain management practices, and patient satisfaction with pain management.

Results:

The 525 study subjects reported high pain intensity levels on presentation, with a median rating of 8 on a 10-point numerical rating scale (NRS). At discharge, pain severity had decreased to a median rating of 4; however, 48% of patients were discharged from the ED in moderate to severe pain (NRS 5–10). Subjects reported spending 57% of their ED stay in moderate to severe pain. Analgesics were administered to only 50% of patients. The mean time to analgesic administration was almost 2 hours. Despite high levels of reported pain at discharge and low rates of analgesic administration, subjects reported high satisfaction with pain management.

Conclusions:

In the 2 EDs studied, we found high levels of pain severity for our patients, as well as low levels of analgesic use. When used, analgesic administration was often delayed. Despite these findings, patient satisfaction remained high. Despite recent efforts to improve pain management practice; oligoanalgesia remains a problem for our specialty.

Type
EM Advances • Innovations en MU
Copyright
Copyright © Canadian Association of Emergency Physicians 2002

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