Management of the acute pain in the emergency department

Abstract

Introduction: Acute pain is the number one complaint in emergency medical care. Despite the published recommendations the management of acute pain (AP) remains an unsolved problem in emergency care. Aim: The aim of this study was to evaluate the management of acute pain as well as the ordinary practice of administering analgesia in EDs. Material and Method: A six-month prospective correlation study was conducted, involving adult patients visiting EDs of Athens with AP. Pain intensity was measured by an 11-point Numerical Rate Scale (NRS) upon admission and before discharge from ED. Results: Mean level of pain upon admission was 7.0 (SD=1.9) and before discharge 4.2 (SD=2.4), (p<0.001). The 53.3% and 43.5% of patients complained of moderate and severe pain respectively. Before discharge, 7.3% of patients reported no pain, 29.7% mild, 51.5% moderate, while the percentage of those with severe pain decreased to 11.5% (p<0.001). Analgesia was administered to 64.2% of patients, while the main administered analgesics were non-opiods (35,8%). The 76.8% of patients with severe pain received analgesics while the percentage of those with mild or moderate pain was 54.5% (p<0.001). Mean time of administering analgesia was 48 minutes. Conclusions: AP was found to be inadequately treated. Opioids were underutilized for the relief of patients with severe pain. Time of administration of analgesia was not satisfactory and analgesics were not appropriate for the observed intensity of pain.