Abstract
Pain is a common complaint in patients attending the emergency department (ED), and historically, it is under-assessed and undertreated. Previous research is heterogeneous and does not well describe pain in EDs over time. Our aim was to describe pain in a UK ED using a sample that included every adult attendance over the course of 1 week. We retrospectively reviewed every adult attendance (N = 1872) over 1 week to the ED of a large English NHS District General Hospital. We noted the initial pain score and, if the initial score was ≥5, the final recorded pain score. We categorised attendances as 'illness' or 'injury'. In all, 62.1% of patients had a pain score recorded, of whom 50.7% had a pain score of zero. Median pain score was 6/10 in patients with pain; 58% had a second score recorded. More patients with illness than injury had a second score recorded. Most patients had an improvement in their pain; however, around one-third had no change or worse pain at the end of their ED stay. We have defined the incidence, severity and change in pain in an ED over 1 week. This information will underpin the design of future studies aimed at improving patient care in this important area of emergency medicine practice.
Highlights
Pain is a common problem among patients attending the emergency department (ED).[1,2,3,4] Previous studies have found both assessment and reassessment of pain to be inadequate, and suboptimal pain management, termed ‘oligoanalgesia’, has been identified as a problem.[5,6] The underlying reasons are likely to be multifactorial and may be hard to change; this is an important area of clinical care.To provide the basis for sample size calculations for future interventional studies in pain management, we needed to know the incidence of pain of various degrees and the natural history of change in pain during routine ED care
We reviewed the notes of every patient and recorded the day of the week, age, presenting complaint, initial pain score and final recorded pain score if the initial score was ≥5
If the patient was initially assessed in the adjoining Urgent Care Centre, we looked at these notes if a pain score was not present elsewhere
Summary
Pain is a common problem among patients attending the emergency department (ED).[1,2,3,4] Previous studies have found both assessment and reassessment of pain to be inadequate, and suboptimal pain management, termed ‘oligoanalgesia’, has been identified as a problem.[5,6] The underlying reasons are likely to be multifactorial and may be hard to change; this is an important area of clinical care. Conclusion: We have defined the incidence, severity and change in pain in an ED over 1 week This information will underpin the design of future studies aimed at improving patient care in this important area of emergency medicine practice
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
