Skip to main content Accessibility help
×
Home

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

  • Knox H. Todd (a1), Edward P. Sloan (a2), Connie Chen (a3), Stephen Eder (a2) and Kyle Wamstad (a1)...

Abstract:

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.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

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

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

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

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

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

Copyright

Corresponding author

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

References

Hide All
1.Wilson, JE, Pendleton, JM.Oligoanalgesia in the emergency department. Am J Emerg Med 1989;7:6203.
2.Selbst, SM, Clark, M.Analgesic use in the emergency department. Ann Emerg Med 1990;19:10103.
3.Todd, KH, Samaroo, N, Hoffman, JR.Ethnicity as a risk factor for inadequate emergency department analgesia. JAMA 1993; 269:15379.
4.Todd, KH, Deaton, C, D’Adamo, AP, Goe, L.Ethnicity and analgesic practice. Ann Emerg Med 2000;35:116.
5.Ducharme, J, Barber, C.A prospective blinded study on emergency pain assessment and therapy. J Emerg Med 1995;13:5715.
6.Joint Commission on Accreditation of Healthcare Organizations. Pain Standards for 2001. Available: www.jcaho.org/trkhco_frm.html (accessed 2002 May 8).
7.Cuzick, J.A Wilcoxon-type test for trend. Stat Med 1985;4:8790.
8.Hoyt, KS, Sparger, G.Pain assessment by ED nurses. J Emerg Nurs 1984;10:30612.
9.Boisaubin, EV.The assessment and treatment of pain in the emergency room. Clin J Pain 1989;5:S1924.
10.Johnston, CC, Gagnon, AJ, Fullerton, L, Common, C, Ladores, M, Forlini, S.One-week survey of pain intensity on admission to and discharge from the emergency department: a pilot study. J Emerg Med 1998;16:37782.
11.Tanabe, PO, Buschmann, M.A prospective study of ED pain management practices and the patient’s perspective. J Emerg Nurs 1999;25:1717.
12.Guru, V, Dubinsky, I.The patient vs. caregiver perception of acute pain in the emergency department. J Emerg Med 2000;18:712.
13.Stahmer, SA, Shofer, FS, Marino, A, Shepherd, S, Abbuhl, S.Do quantative changes in pain intensity correlate with pain relief and satisfaction? Acad Emerg Med 1998;5:8517.
14.Blanchard, DK, Todd, KH.More satisfactory measures of emergency department patient satisfaction [abstract]. Acad Emerg Med 1997;4:498.

Keywords

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

  • Knox H. Todd (a1), Edward P. Sloan (a2), Connie Chen (a3), Stephen Eder (a2) and Kyle Wamstad (a1)...

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed