Abstract
Objective: Current study was conducted to develop a pain control protocol by Morphine Sulfate (MS) Suppository in triage ward with the main primary outcomes of first analgesic administration time, patients' satisfaction and also the changes in pain intensity. Methods: In this randomized clinical trial, 318 consecutive patients attending to an academic tertiary health care center in Tehran, Iran in 2011 and 2012 were enrolled. The patients were randomly assigned to receive either routine pain control by emergency medicine residents in emergency department (n=132) or pain control protocol in triage level by nurses (n=186). Those with pain in control group were treated with conventional pain control program and those in intervention group with pain intensities higher than four were treated with suppository stat 10 mg dose of MS administered by nurses in triage ward. Results: The mean change in pain intensity was significantly (P<0.0001) higher in intervention group (4.2 versus 0.2) and the first analgesic administration time was significantly different between groups (P<0.05) being less in the intervention group (43.1 versus 4.6). Also the patients' satisfaction was significantly higher in the intervention group (P<0.0001). No drug adverse effects were seen. Conclusions: Totally, according to the obtained results, it may be concluded that acute pain control protocol in triage department by suppository of MS would result in reduced analgesics administration time and higher patients' satisfaction. Keywords: Analgesia; Emergency Department; Pain Control
Highlights
Insufficient analgesics prescription in emergency department has been evaluated in different studies [1,2,3,4]
The mean change in pain intensity was significantly (P
Totally, according to the obtained results, it may be concluded that acute pain control protocol in triage department by suppository of MS would result in reduced analgesics administration time and higher patients' satisfaction
Summary
Oligoanalgesia has been an important concern in emergency medicine since 1990s [1]. The shortness in this field would be more when seeing the pain as the most common symptom among patients attending the emergency departments [5,6,7]. Recent studies demonstrated that pain management guidelines in triage level would result in better pain control in a shorter time [8,9]. Regarding to importance of pain management in emergency department and high prevalence of pain in patients and prolonged waiting for analgesic administration, different studies have been conducted to develop a guideline for urgent pain control in triage level. Some studies have shown low efficacy for this method [10]
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